超分割放疗加化疗治疗晚期鼻咽癌的前瞻性临床研究

目的　探讨超分割放疗加化疗治疗晚期鼻咽癌的临床效果和反应。方法　 6 0例鼻咽癌患者随机分入超分割加同期化疗组 (研究组 )和单纯超分割放射治疗组 (对照组 )。放射治疗方法两组相同 ,鼻咽部放疗方案为 1.2Gy·次- 1 ,每天 2次 ,间隔 >6h ,总剂量 74Gy ;颈淋巴结 (+)给予治疗量 ,DT79Gy。化疗用PFL方案 :顺铂 6 0mg·m- 2 ,第 1天 ,氟尿嘧啶 75 0mg·m- 2 ,第 2～ 4天 ,亚叶酸钙 10 0mg·m- 2 ,第 2～ 4天 ,每 4周重复。研究组放射、化疗同期进行。结果　研究组的病灶全消率优于对照组 (P <0 .0 5 ) ,但皮肤黏膜Ⅲ度放射反应较多 (P <0 .0 5 )。 1年、3年和 5年生存率研究组和对照组分别为 96 % ,6 7% ,4 3%和 73% ,4 3% ,33%。结论　超分割放疗加化疗治疗晚期鼻咽癌的疗效优于单纯超分割放射治疗 ,晚期鼻咽癌患者加用化疗是合理的

A prospective trial of treating patients with nasopharyngeal carcinoma in late stage by combined hyperfractionated radiotherapy and concurrent chemotherapy

Objective To evaluate the therapeutic effect and reactions of hyperfractionated radiotherapy combined with concurrent chemotherapy for nasopharyngeal carcinoma (NPC) in stages Ⅲ and Ⅳ. Methods Sixty previously untreated NPC patients were randomly assigned to hyperfractionated radiotherapy plus chemotherapy(experimental group)and hyperfractionated radiotherapy (control group). Irradiation dose to the NPC foci were: experimental group 1.2?Gy/f, 2f/d, to a total dose of 75.5?Gy; for neck nodes: 79?Gy to patients with positive nodes. PFL was used in chemotherapy regimen: PDD: 60?mg·m -2, d1; 5-FU 750?mg·m -2,d2～4, Lv 100?mg·m -2,d2～4, q4w. Results The experimental group had a higher complete regression rate of tumor and a higher 1, 3 and 5 year survival rate than the control group (P< 0.05), but it had more serious irradiation reactions than the control group(P< 0.05). Conclusion Hyperfractionated radiotherapy plus chemotherapy has better therapeutic effects with tolerable reactions. Therefore, combination of hyperfractionated radiotherapy with chemotherapy regimen for NPC patients seems justified.