摘要
目的：观察以后程三维适形放疗（3DCRT）为主治疗初治鼻咽癌的临床疗效及毒副反应。方法：38例初治鼻咽癌患者,接受以后程3DCRT为主的治疗。化疗方案为顺铂（DDP）加5-氟尿嘧啶（5-Fu）同期或诱导1-4个周期（中位2个周期）。结果：中位随访34个月,死亡5例。全组1、2、3年生存率和局部控制率分别为100%、91.2%、81.6%和97.3%、94.4%、82.2%。放化综合治疗组1、2、3年生存率和局部控制率分别为100%、88.2%、80.2%和94.4%、88.8%、76.2%,单纯放疗组1、2、3年生存率和局部控制率分别为100%、94.1%、82.3%和100%、100%、87.5%,两组进行比较,生存率和局部控制率差异均无显著性（P〉0.05）。毒性反应较低,均能按时完成治疗。结论：后程3DCRT用于鼻咽癌治疗,配合足够周期的化疗,可望达到更好的局部控制率和降低远处转移率。
Objective： To observe the curative results and toxic or side effect of three dimensional conformal radiotherapy （3DCRT） in the treatment of untreated nasopharyngeal carcinoma （NPC）.Methods： Thirty-eight patients with NPC received 3DCRT as the first-line treatment. According to the 1992 Fuzhou staging system, patients were identified as： 1 at stage Ⅰ , 9 at stage Ⅱ , 16 at stage m, and 12 at stage Ⅳ a. All the patients were divided into radio-chemical combination treatment group （RCG, 19 cases） and radiotherapy only group （RTG, 19 cases）. Patients in group RCG received concomitant chemorradiation or new-adjuvant chemotherapy 2 cycles （range, 1-4cycle） with DDP and 5-FU. An initial conventional fraction 36 Gy/18 f/24 d for face and neck port was given to all of the patients, and then, 3DCRT was used in nasopharyngeal region 34 -46 Gy/17 -23 f/24 -34 d. The nasopharyngeal region was given radiotherapy with lymph note metastasis was given radical with a median of 76 Gy （range, 70 -82 Gy）. The neck radiotherapy with a median of 50 Gy （range, 60 -80 Gy）. Node-negative neck was given prophylatic radiotherapy with a median of 50 Gy （range, 40 -60 Gy）. Results： The median follow-up period was 34 months. Five patients died. The general1-, 2- and 3-year survival rates and regional control rates were 100%, 91.2%, 81.6% and 97.3%, 94.4%, 82.2% , respectively. Those of patients in group RCG were 100%, 88.2% , 80.2% and 94.4%, 88.8%, 76.2%, and in group RTG were 100%, 94.1%, 82.3% and 100%, 100%, 87.5% , respecttively. No obvious difference was found between the two groups （ P 〉 0.05 ）. There were less toxicities during the treatment. All of the patients accomplished the treatment on schedule. Conclusion： A better regional control and less distant metastasis can be obtained in NPC by using 3DCRT combing with enough chemotherapy cycles.
出处
《贵阳医学院学报》
CAS
2007年第5期480-483,共4页
Journal of Guiyang Medical College
关键词
鼻咽肿瘤
放射疗法
顺铂
氟尿嘧啶
三维适形放疗
nasopharyngeal neoplasms
radiotherapy
cisplatin
fluorouracil
three dimensional conformal radiotherapy
