摘要
目的：评价大剂量Ｃｉｓｐｌａｔｉｎ，５－Ｆｕ及ＢＬＭ新辅助化疗在中晚期鼻咽癌治疗中的价值。材料及方法：１９９２～１９９３年，４４０例治疗前行ＣＴ或ＭＲ检查确诊为Ⅲ、Ⅳａ期鼻咽癌（＇９２分期），随机分为化疗＋放疗组（２１９例），及单纯放疗组（２２１例）。化疗方案：Ｃｉｓｐｌａｔｉｎ：２０ｍｇ／ｍ２１～５天，５－Ｆｕ５００ｍｇ／ｍ２１～５天，ＢＬＭ：７ｍｇ／ｍ２１、５天，化疗两个疗程。放射治疗鼻咽剂量：６６～７４Ｇｙ／（３３～３７次）·（７～９周）。颈部淋巴结剂量：６０～７０Ｇｙ／（３０～３５次）·（７～８５周），颈部预防量：４８～５０Ｇｙ。生存分析采用总生存率，无瘤生存率，无局部区域复发生存率、无远处转移生存率，无局部复发生存率。结果：５年生存率及无远处转移生存率：实验组及对照组分别为５７１７％ＶＳ５１０７％（Ｐ＞０．０５）及７５５３％ＶＳ７３２４％（Ｐ＞０．０５）；无瘤生存率及无局部区域复发生存率分别为５５１３％ＶＳ４５３４％（Ｐ＞０．０５）及７２４３％ＶＳ６２２０％（Ｐ＞０．０５）。Ｔ３、Ｔ４无局部复发率分别为８１４０％ＶＳ６７４３％（Ｐ＜Ｏ．０５）及７００５％ＶＳ５８４０％（Ｐ?
Purpose: To evaulate neoadjuavant chemotherapy of high dose Cisplatin, 5-Fu and BLM in treatment of advanced Nasopharyngeal Carcinoma. Materials and Method: From 1992 to 1993, 440 cases of diagnosed stage Ⅲ Ⅳa nasopharyngeal carcinoma patients ('92 stage system), fininshed CT or MR scan before treatment, were randomied into two groups. One is chemotherapy plus radiotherapy. The other is radiotherapy alone. Chemoregime: Cisplatin: 20mg/m2 d1-5,5-Fu: 500 mg/m2 d1-5 and BLM: 7 mg/m2 d1,5. Two courses are finished. Radiotherapy: The NpDT and LNDT are 66～74 Gy/(33～37 f)·(7～9 weeks), 60～70 Gy/(30～35 f)·(7～8.5 weeks), respectively. The prophylatic dose of neck was 48～50 Gy. The survival analysis is conducted with survival rate, disease-free, free from local-regional, free from distant metastasis and free from local survival rate. Results: The five-year survival rate and free from distant metastasis survival rate: The experimental and control group are 57.17% VS 51.07% (P>0.05),75.53% VS 73.24% (P>0.05),respectively. Disease-free and free from local-regional survival rate are 55.13% VS 45.34% (P>0.05), 72.43% VS 62.20% (P>0.05), respectlvely. The free from local survival rate of T3 and T4 are 81.40% VS 67.43% (P<0.05),70.05% VS 58.40% (P<0.05), respectively. Conclusion: Two courses of neoadjuvant chemotherapy of high dose of Cisplatin, 5-Fu and BLM could not yeild a higher survival rate and a lower distant metastasis rate. It may have a positive effeet on disease-free and free from local-regional svrvival rate. On the basis of present radiotherapy level, it signifcantly elevates the local control rate of advanced T stage (T3,T4) for Nasopharyngecl Carcinoma patients.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
1998年第4期274-277,共4页
Chinese Journal of Cancer
基金
鼻咽癌"八·五"攻关课题资助
关键词
鼻咽肿瘤
化学疗法
佐剂
放射疗法
生存分析
Nasopharyngeal Neoplosms
Chemotherapy,Adjuvant
Radiotherapy
Survival analysis
