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[目的]比较诱导化疗+同期放化疗(ICRT)和诱导化疗+放疗(IRT)治疗Ⅲ、Ⅳa期鼻咽癌患者的疗效及毒副反应。[方法]70例经病理组织学确诊为Ⅲ、Ⅳa期鼻咽癌初诊患者随机分为ICRT组(n=34)和IRT组(n=36)。IRT组接受诱导化疗+放疗,ICRT组接受诱导化疗+同期放化疗。[结果]ICRT组和IRT组患者5年总生存率(70.6%vs77.8%,χ2=0.581,P=0.446),无瘤生存率(67.6%vs63.9%,χ2=0.012,P=0.913),无局部区域复发生存率(91.2%vs83.3%,χ2=0.763,P=0.382),无远处转移生存率(76.5%vs77.8%,χ2=0.102,P=0.749)均无显著性差异。ICRT组外周血白细胞减少、中性粒细胞减少、血小板减少、呕吐和急性咽黏膜等反应重于IRT组(P<0.05)。[结论]与诱导化疗+放疗相比,诱导化疗+同期放化疗无明显提高Ⅲ、Ⅳ期鼻咽癌的疗效,且毒副反应较大。
[Objective] To compare the curative effect and side effects of induction chemotherapy + concurrent chemoradiotherapy (ICRT) and induction chemotherapy + radiotherapy (IRT) in patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma. [Method] Seventy patients newly diagnosed as stage Ⅲ and Ⅳa nasopharyngeal carcinoma by histopathology were randomly divided into ICRT group (n = 34) and IRT group (n = 36). IRT group received induction chemotherapy + radiotherapy, ICRT group received induction chemotherapy + concurrent radiotherapy and chemotherapy. [Results] The 5-year overall survival rates in ICRT group and IRT group were 70.6% vs77.8% (χ2 = 0.581, P = 0.446), and the tumor-free survival rates were 67.6% vs63.9% ,χ2 = 0.012 ), No recurrence survival rate in local area (91.2% vs83.3%, χ2 = 0.763, P = 0.382), no distant metastasis survival rate (76.5% vs77.8%, χ2 = 0.102, P = 0.749) Sex differences. ICRT group peripheral leukopenia, neutropenia, thrombocytopenia, vomiting and acute pharyngeal mucosa and other reactions than the IRT group (P <0.05). [Conclusion] Compared with induction chemotherapy and radiotherapy, induction chemotherapy and concurrent chemoradiotherapy did not significantly improve the efficacy of stage Ⅲ and Ⅳ nasopharyngeal carcinoma, and the toxicity was higher.