广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2001年
2期
235-237
,共3页
阮展鸿%陈甲信%卢晓宁%谭祥干
阮展鴻%陳甲信%盧曉寧%譚祥榦
원전홍%진갑신%로효저%담상간
鼻咽癌%放疗%化疗
鼻嚥癌%放療%化療
비인암%방료%화료
目的：探讨一种适合对鼻咽癌进行综合治疗的方法。方法：对153例鼻咽癌随机分组研究；单纯放疗组(甲组)52例、放疗前诱导化疗组(乙组)52例、放疗同步化疗组(丙组)49例，各组均采用60Coγ射线或4MVX线常规分割放疗，颈部加180KVX射线。鼻咽部剂量70～80Gy/7～8W，颈部预防照射50Gy/5W，根治量60～75Gy/6～7.5W。乙组在放疗前予DDP50mg，第1，5天，5-Fu500mg，第1～5天，静滴，休息2周，再重复上述方案。丙组在放疗开始同时给予DDP20mg,第1～5天，5-Fu 500mg，第1～5天，静滴，第4周再重复上述方案。结果：甲、乙、丙组鼻咽部肿瘤完全消退率为90.4％、75.0％、89.8％。颈部转移灶除N0者外，全消率分别为75.7％、64.5％、75.0％。按临床分期比较消退率Ⅱ、Ⅲ、Ⅳa期，甲组分别为85.7％、71.4％、60％，乙组分别为70％、58.3％、66.6％，丙组分别为81.3％、72.7％、63.4％。但经统计学处理，均无显著性差异(P＞0.05)。结论：鼻咽癌综合治疗与单纯放疗疗效比较，晚期病例的近期疗效稍有提高，长期疗效有待进一步观察。
目的：探討一種適閤對鼻嚥癌進行綜閤治療的方法。方法：對153例鼻嚥癌隨機分組研究；單純放療組(甲組)52例、放療前誘導化療組(乙組)52例、放療同步化療組(丙組)49例，各組均採用60Coγ射線或4MVX線常規分割放療，頸部加180KVX射線。鼻嚥部劑量70～80Gy/7～8W，頸部預防照射50Gy/5W，根治量60～75Gy/6～7.5W。乙組在放療前予DDP50mg，第1，5天，5-Fu500mg，第1～5天，靜滴，休息2週，再重複上述方案。丙組在放療開始同時給予DDP20mg,第1～5天，5-Fu 500mg，第1～5天，靜滴，第4週再重複上述方案。結果：甲、乙、丙組鼻嚥部腫瘤完全消退率為90.4％、75.0％、89.8％。頸部轉移竈除N0者外，全消率分彆為75.7％、64.5％、75.0％。按臨床分期比較消退率Ⅱ、Ⅲ、Ⅳa期，甲組分彆為85.7％、71.4％、60％，乙組分彆為70％、58.3％、66.6％，丙組分彆為81.3％、72.7％、63.4％。但經統計學處理，均無顯著性差異(P＞0.05)。結論：鼻嚥癌綜閤治療與單純放療療效比較，晚期病例的近期療效稍有提高，長期療效有待進一步觀察。
목적：탐토일충괄합대비인암진행종합치료적방법。방법：대153례비인암수궤분조연구；단순방료조(갑조)52례、방료전유도화료조(을조)52례、방료동보화료조(병조)49례，각조균채용60Coγ사선혹4MVX선상규분할방료，경부가180KVX사선。비인부제량70～80Gy/7～8W，경부예방조사50Gy/5W，근치량60～75Gy/6～7.5W。을조재방료전여DDP50mg，제1，5천，5-Fu500mg，제1～5천，정적，휴식2주，재중복상술방안。병조재방료개시동시급여DDP20mg,제1～5천，5-Fu 500mg，제1～5천，정적，제4주재중복상술방안。결과：갑、을、병조비인부종류완전소퇴솔위90.4％、75.0％、89.8％。경부전이조제N0자외，전소솔분별위75.7％、64.5％、75.0％。안림상분기비교소퇴솔Ⅱ、Ⅲ、Ⅳa기，갑조분별위85.7％、71.4％、60％，을조분별위70％、58.3％、66.6％，병조분별위81.3％、72.7％、63.4％。단경통계학처리，균무현저성차이(P＞0.05)。결론：비인암종합치료여단순방료료효비교，만기병례적근기료효초유제고，장기료효유대진일보관찰。
Objective: To study the methods of combination treatment nasopharygeal carcinoma. Methods: 153 patients with nasopharygeal carcinoma were randomly divided into three groups. 49 patients radiotherapy (RT) alone (group A). 52 patients received induction chemotherapy before RT with DDP (50mg,d1,5), 5-Fu (500mg, d1～5) for 2 cycles (group B). 52 patients received chemotherapy with DDP (20mg, d1～5), 5-Fu (500mg, d1～5) in first and fourth week of RT (group C). RT in three groups was similar, patients in convention factionation received 2Gy/per fraction, five fraction/per week, with the total dose of 70～80Gy/7～8 week to nasopharynx, 60～75Gy/6～7.5 week to lymph nose node involvement and 50Gy in regionally lymphatic drainage. Results: Nasopharynx complete remission rate of group A, group B and group C were 90.4%, 75.0% and 89.8% respectively (P＞0.05). Cervical node complete remission rate of group A, group B and group C were 75.7%, 64.5% and 75.0%, respectively (P＞0.05). At Ⅱ stage, CR rate of group A, group B and group C were 85.7%, 70% and 81.3%,respectively (P＞0.05). At Ⅲ stage, CR rate of group A, group B and group C were 71.4%, 58.3% and 72.7%, respectively (P＞0.05). At Ⅳa stage, CR rate of group A, group B and group C were 60%, 66.6 % and 63.4%, respectively (P＞0.05). Conclusions:The near-term results of combination treatment for advanced nasopharygeal carcinoma is better than radiotherapy alone. The long-term survival remains to be answered.
