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目的比较单纯放疗及放疗联合每周顺铂方案治疗局部晚期鼻咽癌(LANPC)的急性和晚期反应及其疗效。方法将52例局部晚期鼻咽癌患者随机分入单纯放疗组(RT组)及放疗联合化疗组(CRT组),两组患者均接受常规放射治疗,CRT组于放射治疗的第1周起静脉滴注顺铂30mg/m~2,每周1次,连续5～7周。结果52例患者均完成了计划剂量的放射治疗,25例患者完成了同期顺铂治疗,急性毒副反应的发生率与RT组相比,差异无统计学意义(P>0.05),两组均未观察到3、4组正常组织的晚期损伤。治疗后3个月时完全缓解率两组间差异无统计学意义(P>0.05)。中位随访48.8个月后,2、4年总生存率、无转移生存率两组间差异有统计学意义(P<0.05);而两组无复发生存率未见明显差异(P>0.05)。结论每周30 mg/m~2顺铂联合放射治疗与单纯放疗相比,能提高局部晚期鼻咽癌患者的生存率,降低远处转移率,同时急性放射反应和晚期放射损伤在患者可接受范围内。
Objective To compare the acute and late response of locally advanced nasopharyngeal carcinoma (LANPC) treated with radiotherapy and radiotherapy combined with weekly cisplatin regimen and its curative effect. Methods Fifty-two patients with locally advanced nasopharyngeal carcinoma were randomly divided into radiotherapy group (RT group) and radiotherapy combined with chemotherapy group (CRT group). Both groups received conventional radiotherapy. In CRT group, the first week after radiotherapy Instillation cisplatin 30mg / m ~ 2, once a week for 5 to 7 weeks. Results All the 52 patients completed the planned dose of radiation therapy. Twenty-five patients completed the cisplatin treatment in the same period. There was no significant difference in the incidence of acute toxicities between the two groups (P> 0.05) No damage to the normal tissues was observed in 3 and 4 groups. The complete remission rate at 3 months after treatment showed no significant difference between the two groups (P> 0.05). After a median follow-up of 48.8 months, there was a significant difference between the two groups in overall survival and metastasis-free survival at 2 and 4 years (P <0.05), but there was no significant difference in relapse-free survival between the two groups (P> 0.05) . Conclusions Weekly radiotherapy combined with 30 mg / m 2 cisplatin can improve the survival rate and reduce the distant metastasis rate in patients with locally advanced NPC, compared with radiotherapy alone. In addition, the acute radiation response and late radiation injury are acceptable in patients Range.