放疗联合紫杉醇化疗治疗中晚期鼻咽癌的疗效观察.docVIP

放疗联合紫杉醇化疗治疗中晚期鼻咽癌的疗效观察 作者：黄杰 赖振南 谢杰荣 吴华 作者单位：广东医学院附属医院肿瘤科（湛江） 【摘要】 目的 观察放疗联合紫杉醇治疗中晚期鼻咽癌患者的疗效。方法 分析放疗联合紫杉醇治疗58例中晚期鼻咽癌的局控率、生存率和毒副反应，并与57例单纯放疗相比较。结果 综合组和单放组的治疗有效率为87.9%、71.9%，颈部淋巴结有效率91.5%、75.4%，差异均有统计学意义（P0.05）。综合组的远处转移率低于单放组（P0.05）。两组1～3年生存率均无统计学意义（P0.05）。综合组主要不良反应为白细胞下降、胃肠道反应等，经治疗可改善。结论 放疗联合紫杉醇可提高中晚期鼻咽癌的近期疗效，毒副反应可耐受，长期疗效有待于临床进一步观察。 【关键词】 鼻咽癌 放疗 紫杉醇 　　Observation on the effect of middle to advanced nasopharyngeal cancer treated by paclitaxel combined with radiotherapy 　　HUANG Jie, et al. 　　(Department of Oncology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001 China) 　　【Abstract】 Objective To explore the curative effect combined paclitaxel with radiotherapy for patients on middle to advanced nasopharyngeal cancer (NPC). Methods To analyze the rates of local control, survival and toxicity of 58 patients treated by paclitaxel chemotherapy in combination with radiotherapy for middle to advanced NPC, and compared with the 57 patients treated by radiotherapy. Results The complete response rate for primary tumor were 87.9% in the chemotherapy plus radiotherapy group (group A), and 71.9% in radiotherapy alone group (group B). The remission rates in the cervical lymph nodes were 91.5% VS 75.4% , both with significant difference (P0.05). The one - year, two - year and three - year survival rates were93.1%, 82.8% and 72.4% in group A, and 89.5%, 78.9%, 68.4% in group B, without significant difference (P0.05). The side effects were leucocytes declining and membranes reaction. Conclusions The radiotherapy plus paclitaxel improved short effects in middle to advanced NPC with tolerable toxicity , and long effects deserve further evaluation. 　　【Key words】 Nasopharyngeal carcinoma Radiotherapy Paclitaxel 　　鼻咽癌主要的治疗手段是放射治疗， 早期病人放疗效果好，5年生存率较高。然而70%左右的患者确诊时已为中晚期，单纯放疗后5年生存率仅为40%左右，治疗失败的主要原因是患者容易局部复发和远处转移［1-3］。鼻咽癌大多数为低分化鳞癌，对化疗较敏感，放化综合治疗近年来成为治疗的标准方案［4-5］。为进一步探讨鼻咽癌放化综合治疗的临床疗效及毒副反应，