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1、誘導(dǎo)化療聯(lián)合同期放化療治療Ⅲ、Ⅳa期鼻咽癌的臨床研究董超1,任艷鑫2,楊潤(rùn)祥1,莊莉1,任宏軒1(1.昆明醫(yī)科大學(xué)第三附屬醫(yī)院腫瘤內(nèi)二科,2.頭頸外科云南昆明650118)摘要:目的評(píng)價(jià)單純放療和誘導(dǎo)化療聯(lián)合同期放化療治療Ⅲ、Ⅳa期鼻咽癌的毒副反應(yīng)、臨床療效和對(duì)生存期的影響。方法統(tǒng)計(jì)2000年至2005年我院診治Ⅲ、Ⅳa期鼻咽癌患者169例,其中113例患者接受單純根治性放療(對(duì)照組),56例患者接受NVB聯(lián)合DDP誘導(dǎo)化療2周期后行根治性放療,同期給予DDP每周方案化療(研究組),兩組患者進(jìn)行臨床療效和毒副反應(yīng)的比較,Kaplan-Meier法計(jì)算5年生存率和無(wú)瘤生存率。結(jié)果
2、研究組的鼻咽腫瘤和頸淋巴結(jié)完全消退率優(yōu)于對(duì)照組(92.8%vs80.5%,85.7%vs72.6%P<0.05)。研究組和對(duì)照組的5年生存率和無(wú)瘤生存率分別為71.70%vs、61.3%和56.6%vs、47.6%。,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。研究組毒性反應(yīng)增加,以骨髓抑制、胃腸反應(yīng)和口腔黏膜炎為主。結(jié)論誘導(dǎo)化療聯(lián)合同期放化療可提高局部晚期鼻咽癌的臨床療效和生存率。毒副反應(yīng)較大,但不影響治療進(jìn)程。關(guān)鍵詞:鼻咽腫瘤; 誘導(dǎo)化療;同期化放療;生存分析ClinicalstudyofInductionChemotherapyPlusConcurrentRadiochemothe
3、rapyintheTreatmentofstageⅢandⅣaadvancedNasopharyngealCarcinomaDONGChao,RENYan-xin,YANGRun-xiang,ZhuangLi,RENHong-xuan.1.Dapartmentofthesecondmedicaloncology,TheThirdAffiliatedHospitalofKunmingMedicalUniversity,Kunming650018,China;2.DapartmentofheadandneckAbstract:objectiveToevaluatetheeffica
4、cyandtoxicityofradiotherapyaloneandinductionchemotherapyplusconcurrentchemoradiotherapyforstageⅢandⅣanasopharyngealcancer(NPC)andtocomparetheinfluenceonsurvivalrates.MethodsToanalysisclinicaldatasof169locallyadvancedNPCpatientsfrom2000to2005.56casesweretreatedtwocyclesofinductionchemotherapy
5、followedbyconventionalradicalradiotherapyandconcurrentweeklycisplatinchemotherapy(studygroup);113weretreatedwithradiotherapyalone(controlgroup).Thetherapeuticresponseandadversereactionofthetwogroupswerecompared.The5-yearoverallanddisease-freesurvivalrateswereanalyzedbyKaplan-Meier.Resultsthe
6、completeresponseratesofthenasopharyngealcontrolandthecervicallymphnodescontrolinstudygroupweresuperiortothatincontrolgroup(92.8%vs80.5%,85.7%vs72.6%P<0.05).The5-yearoverallsurvivalratesinstudygroupandcontrolgroupwere71.7%and56.6%respectively.Thedisease-freesurvivalratesintwogroupswere61.3%an
7、d47.6%。The5-yearoverallanddisease-freesurvivalratesweresignificantlyhigherinstudygroupthanincontrolgroup(P<0.05).Theratesoftoxicityeffectinstudygroupwerehigherthanincontrolgroup.themaintoxicitywas8hematologicaltoxicties,gastrointestinalreactionando