摘要
目的 研究探讨加用化疗对中晚期鼻咽癌放疗疗效的影响。方法 54 例Ⅲ、Ⅳ期鼻咽癌随机分为两组(放疗组和放化疗组)。放疗组28例采用60Co 以常规分割及分段治疗的方式照射鼻咽、颈部、颅底三个部位。鼻咽部剂量56～75 Gy,颈部预防量50 Gy,治疗量56～66 Gy。放化疗组26例除按上述放疗外,在放疗前后各行一疗程化疗(5-FU 2.5m g+ DDP150 m g+ Pingyingm ycin 32 m g)。结果 单纯放疗组和放化疗组的肿瘤消退率分别为82.40 % ,88.46 % (P> 0.05);颈部转移灶完全消退率分别为92.86 % ,92.31 %(P> 0.05);3 年生存率为53.70 % ,60.54 % (P> 0.05);三年无瘤生存率为43.57 % 和51.54 % (P> 0.05);远处转移率35.71 % 和11.54 % (P< 0.05);出现远处转移的平均时间放疗组为23 个月,放化疗组为32个月(P< 0.02);放疗组恶心呕吐7.14 % ,放化疗组57.69 % (P< 0.001);白细胞下降分别为28.57 % 和73.08 % (P< 0.001);血小板下降21.43 % 和38.46 % 及血色素下降17.86 % 和23.08 % (均P> 0.05);放疗组口腔粘膜糜烂反应42.85 % ,放化疗组69.23 % (P> 0.05)。结论 放疗加化疗未能提高病人生存率和无瘤生存率,但可减低远处转移率。
Objective The effect on efficacy of pre and post irradiation chemotherapy for median and late stages of nasopharyngeal carcinoma was investigated. Methods 54 cases of stage Ⅲ and Ⅳ cancer patients were divided randomly into group 1 and group 2. In group 1, 28 cases were treated by 60 Co with 56～75 Gy for nasopharynx and 56～66 Gy for neck region. In group 2, 26 cases received additional pre and post irradiation chemotherapy (5FU 2 5 mg, DDP 150 mg, Pingyingmycin 32 mg).Results The tumor subsidence rates of group 1 and 2 were 82 40 % and 88 46 % respectively ( P >0 05), the complete tumor eliminating rates of neck metastases were 92 86 % and 92 31 % ( P >0 05), the 3 year suvival rates were 53 70 % and 60 54 % ( P >0 05), the 3 year tumor free rates were 43 57 % and 51 54 % ( P >0 05), the metastatic rates were 35 71 % and 11 54 % ( P <0 05), the periods of metastasis appearance were 23 months and 32 months ( P <0 02), the nausea and vomit rates were 7 14 % and 57 69 % ( P <0 001), the wbc decrease rates were 28 57 % and 73 08 % ( P <0 001), the platelet decrease rates were 21 43 % and 38 46 % ( P >0 05), the hemoglobin decrease rates were 17 86 % and 23 08 % ( P >0 05), and the oral mucosa erosion rates were 42 85 % and 69 23 % ( P >0 05). Conclusion Radiotherapy plus chemotherapy did not increase the survival rate nor the tumor free survival rate, but can decrease the metastatic rate. More active chemotherapy may influence the continuation of radiotherapy and patient's life quality.$$$$
出处
《肿瘤》
CAS
CSCD
北大核心
2000年第1期56-57,共2页
Tumor
关键词
鼻咽癌
放射疗法
药物疗法
Nasopharyngeal carcinoma
Radiotherapy
Chemotherapy
