本文選題：鼻咽癌　切入點：放射治療　出處：《廣西醫(yī)科大學》2011年碩士論文

【摘要】：目的:評價放療聯(lián)合順鉑不同劑量方案同期化療治療鼻咽癌的急性毒副反應及近期療效。 方法:從2010年3月至2010年10月共160例患者進入本研究,根據(jù)順鉑使用方案不同采用隨機數(shù)字表法分為八個組(A組:DDP100mg/m~2,1天用,q4w;B組:100mg/m~2,分3天用;q4w;C組:DDP80mg/m~2,1天用,q4w;D組:DDP80mg/m~2,分3天用,q4w;E組:DDP100mg/m~2,1天用,q3w;F組:DDP100mg/m~2,分3天用,q3w;G組:DDP80mg/m~2,1天用,q3w;H組:DDP80mg/m~2,分3天用,q3w;共2周期)。所有入組患者均接受根治性放療方案,放療技術(shù)采用調(diào)強放療(IMRT)或常規(guī)放療(CRT),鼻咽部原發(fā)灶劑量68-78Gy,頸部轉(zhuǎn)移灶劑量62-78Gy,頸部預防劑量54-56Gy。同期化療按所在組要求采用單藥順鉑化療。詳細記錄及評價治療過程出現(xiàn)的各種毒副反應,并積極處理。放療結(jié)束時復查鼻咽鏡、鼻咽及頸部CT或MRI,行療效評價。結(jié)果:各組病例在一般臨床資料方面具有可比性。各組的急性毒副反應發(fā)生率無顯著差異,所有的并發(fā)癥經(jīng)對癥支持治療后均能恢復。在治療依從性方面,3例(D、G、H組各1例)患者出現(xiàn)放療中斷;有5例患者未完成第二周期化療(A組:3例,D組:1例,G組:1例),行Logistic回歸分析結(jié)果顯示女性患者白細胞下降發(fā)生率明顯高于男性患者(P=0.012),而年齡、病理類型、臨床分期及放療技術(shù)對各毒副反應的發(fā)生均無顯著相關(guān)性。近期療效方面,各組患者均得到有效緩解。 結(jié)論:順鉑100mg/m~2與80mg/m~2及不同的劑量分割和間隔時間同期化療治療鼻咽癌的急性毒副反應發(fā)生率及治療依從性無顯著差異,近期療效相似。
[Abstract]:Objective: to evaluate the acute side effects of radiotherapy combined with cisplatin in the treatment of nasopharyngeal carcinoma (NPC). Methods: from March 2010 to October 2010, 160 patients were enrolled in this study. According to the scheme of cisplatin use, eight groups were randomly divided into eight groups: group A: DDP100mgmmmmmmmm2a, group B: 100mg / mm2; group C: DDP80mgmmmm-2; group C: DDP80mgmmm2a / d; group Q4wD: DDP80mgmmm-2; group DDP100mgmmmmm-2: DDP100mgmmm-1 / 21d; group DDP100mgmmgmm-2 / 2; group DDP100mgmmgmmm-2: DDP100mgmmgmm-2 / 2w / 2w / d, respectively. All patients were treated with radical radiotherapy. The radiotherapy technique was IMRT or CRT, the primary dose of nasopharynx was 68-78 Gy, the dose of cervical metastasis was 62-78 Gy, and the dose of cervical prophylaxis was 54-56 Gy. Chemotherapy at the same time was treated with single drug cisplatin according to the requirements of the group. The treatment was recorded and evaluated in detail. All kinds of toxic and adverse reactions, At the end of radiotherapy, nasopharyngoscope, nasopharynx and neck CT or MRI were reviewed to evaluate the curative effect. Results: the general clinical data were comparable in each group, but there was no significant difference in the incidence of acute toxic side effects in each group. All the complications were recovered after symptomatic support treatment. Logistic regression analysis showed that the incidence of leukopenia in female patients was significantly higher than that in male patients. There was no significant correlation between clinical staging and radiotherapy. Conclusion: there is no significant difference in the incidence of acute side effects and therapeutic compliance between cisplatin 100mg/m~2 and 80mg/m~2, different dose partitioning and interval chemotherapy for nasopharyngeal carcinoma, but the short-term curative effect is similar.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R739.63

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