同期放化疗治疗中晚期鼻咽癌的疗效观察_临床医学论文.docVIP

同期放化疗治疗中晚期鼻咽癌的疗效观察_临床医学论文 同期放化疗治疗中晚期鼻咽癌的疗效观察_临床医学论文 作者：蓝玉宏　马慧敏　杨清绪【摘要】 目的 观察同期放化疗治疗中晚期鼻咽癌的疗效。方法 100例确诊为中晚期鼻咽癌患者随机分为同期放化疗组(A组)50例和单纯放疗组(B组)50例，A组在放射治疗的第1、4周给予2个周期顺铂加5氟尿嘧啶方案化疗；B组只给单纯放射治疗。结果 A组完全缓解率84．0%(42/50)高于B组64．0%(32/50)(χ2=4．18，0．05)；A组1、3年生存率分别为94．0%(47/50)、72．0%(36/50)，高于B组88．0%(44/50)、54．0%(27/50)(χ2=0．80，Pgt;0．05，χ2=4．75，0．05)；A组局部复发率8．0%(4/50)明显低于B组26．0%(13/50)(χ2=3．85，0．05)；A组3年远处转移率分别为14．0%(7/50)明显低于B组32．0%(16/50)(χ2=4．12，0．05)。A组黏膜损伤54．0%(27/50)明显高于B组29．4%(10/50)(χ2=4．38，0．05)。结论 同期放化疗可以降低远处转移和提高3年生存率，其毒性反应可以耐受，值得在临床中推广。 　　【关键词】鼻咽癌；晚期放疗；放化疗 　　　 　　【Abstract】 Objective To evaluate the curative effect of radiotherapy combined with concurrent chemotherapy for the treatment of advanced nasopharyngeal carcinoma.Methods 100 cases with advanced nasopharyngeal carcinoma(stage III and IVa)were randomized into 2 groups.Group A received radiotherapy with concurrent chemotherapy(n=50)and Group B received radiotherapy alone(n=50).A group of radia-tion therapy in the 1,4 weeks to give 2 cycles of cisplatin plus 5-fluorouracil chemotherapy;B group only to radiation therapy alone.Results The rate of complete remission were 84．0%(42/50)in A grouphigher than the 64．0%(32/50)in B group(χ2=4．18,0．05);The rates of 1,3-year survival were 94．0%(47/50)，72．0%(36/50)in A group higher than the 88．0%(44/50), 54．0%(27/50)in B group(χ2=0．80,χ2=2．75， 0．05); The rate of local recurrence were 8．0 percent(4/50)in A group were significantly lower than 26．0%(13/50)in B group(χ2=3．85,0．05);The rate of distant metastasis of 3-year were 14．0%(7/50)in A Group were significantly lower than 32．0%(16/50)in B Group(χ2=4．12,0．05);the mucosal injury were 54．0%(27/50)in A group were significantly higher than 29．4%(10/50)in B group(χ2=4．38，0．05).Conclusion Radiotherapy with concurrent chemotherapy can improve the 3-year survival rate and decrease the distant metastasis rate in patients with advanced nasopharyngeal carcinoma. 　　【Key words】Nasopharyngeal carcinoma; Advanced;Radiotherapy;Chemoradiother