本文選題：局部晚期鼻咽癌 + 誘導(dǎo)化療��； 參考：《臨床耳鼻咽喉頭頸外科雜志》2014年06期

【摘要】：目的:探討放化療交替療治療局部晚期鼻咽癌的臨床療效。方法:回顧性分析106例局部晚期鼻咽癌患者臨床資料。單純放療15例;91例接受PF方案為基礎(chǔ)的誘導(dǎo)化療和(或)輔助化療,其中誘導(dǎo)化療加放療加輔助化療36例,誘導(dǎo)化療加放療25例,放療加輔助化療30例。誘導(dǎo)化療1~2周期,輔助化療3~6周期。放療于誘導(dǎo)化療結(jié)束后第1天進(jìn)行,輔助化療在放療結(jié)束后1周開始進(jìn)行。鼻咽原發(fā)灶采用60 Co,常規(guī)分割照射68~74Gy,頸部根治量60~70Gy,頸部預(yù)防量48~50Gy,每組均完成根治量放療。結(jié)果:中位隨訪時(shí)間51個(gè)月,58例患者死亡,全組總生存率為45.3%。單純放療、誘導(dǎo)化療加放療加輔助化療、誘導(dǎo)化療加放療、放療加輔助化療的5年總生存率分別為33%、63%、60%、50%,無瘤生存率分別為13%、56%、48%、40%,無局部復(fù)發(fā)率分別為13%、53%、48%、50%,無遠(yuǎn)處轉(zhuǎn)移率分別為6%、50%、44%、47%,均差異有統(tǒng)計(jì)學(xué)意義(P0.05)。各組發(fā)生復(fù)發(fā)、轉(zhuǎn)移的中位時(shí)間分別為22、29、28、25個(gè)月;10、19、15、12個(gè)月,均差異無統(tǒng)計(jì)學(xué)意義(P0.05)。誘導(dǎo)化療加放療加輔助化療組急性毒性反應(yīng)較其他組重,但未影響治療進(jìn)程,患者均可耐受。結(jié)論:誘導(dǎo)化療和輔助化療聯(lián)合盡早開始的放療治療局部晚期鼻咽癌療效較好,不良反應(yīng)輕,適合局部晚期鼻咽癌患者的綜合治療。
[Abstract]:Objective: to investigate the clinical effect of alternate radiotherapy and chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods: the clinical data of 106 patients with locally advanced nasopharyngeal carcinoma were retrospectively analyzed. Only 15 cases of radiotherapy were treated with induced chemotherapy and / or adjuvant chemotherapy based on PF regimen, including 36 cases of induced chemotherapy plus radiotherapy plus adjuvant chemotherapy, 25 cases of induced chemotherapy plus radiotherapy, and 30 cases of radiotherapy plus adjuvant chemotherapy. Induction chemotherapy was 1 ~ 2 cycles and adjuvant chemotherapy was 3 ~ 6 cycles. Radiotherapy was performed on the first day after induced chemotherapy, and adjuvant chemotherapy began 1 week after radiotherapy. Nasopharynx primary focus was treated with 60 Co. conventional fractionation irradiation was performed at 68m 74 Gy, neck radical cure was 6070 Gy, neck prophylaxis was 480.50 Gy, and radiotherapy was completed in each group. Results: the median follow-up time was 51 months and 58 patients died. The overall survival rate was 45.3%. Radiotherapy alone, induction chemotherapy plus radiotherapy plus adjuvant chemotherapy, induction chemotherapy plus radiotherapy, The 5-year overall survival rate of radiotherapy plus adjuvant chemotherapy was 330.The tumor-free survival rate was 135.56 and 48m, respectively. The local recurrence rate was 13535348and 50cm, respectively, and the non-distant metastasis rate was 60.500.The difference was statistically significant (P 0.05). The median time of recurrence and metastasis in each group was 2229 / 28, 1019 / 15 and 12 / 12, respectively. There was no significant difference between the two groups (P 0.05). The acute toxicity of induced chemotherapy plus radiotherapy plus adjuvant chemotherapy was more severe than that of other groups, but it did not affect the course of treatment. Conclusion: induction chemotherapy combined with adjuvant chemotherapy combined with early radiotherapy is effective in treating locally advanced nasopharyngeal carcinoma with mild adverse reactions and is suitable for comprehensive treatment of locally advanced nasopharyngeal carcinoma.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院耳鼻咽喉-頭頸外科;
【基金】：國家自然科學(xué)基因(No:30901661)
【分類號(hào)】：R739.63

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