CAJ | 학술논문

目的观察鼻咽癌放、化疗配合颈部淋巴结微波热疗的近期及远期疗效.方法 154例初治N2～N3期鼻咽癌患者分为2组:对照组78例,5-氟脲嘧啶+顺铂联合化疗,21 d为1周期,化疗1～2周期后行常规放疗,原发灶放疗剂量DT70～78 Gy/35～39 f,47～51 d.颈淋巴结转移灶DT68～72 Gy/34～36 f,46～50 d;热疗组76例,放、化疗方法同对照组,颈淋巴结于放疗第1天开始配合局部微波热疗,每次有效加温时间45 min,每周2次,共8～14次.结果热疗组和对照组的颈淋巴结完全消退率分别为80.3%和61.5%,差异有统计学意义(P<0.05),总有效率分别为100%和96.2%.热疗组与对照组的颈淋巴结完全消退时的放疗剂量分别为(45.8±5.46)Gy和(58.8±5.03)Gy,差异有统计学意义(P<0.01).热疗组与对照组的5年颈淋巴结局控率分别为97.4%和76.9%,差异有统计学意义(P<0.05).热疗组与对照组1,3,5年生存率分别为97.4%和93.6%(P>0.05)、76.3%和52.6%(P<0.01)、59.2%和41.0%(P<0.05).结论对N2、N3期鼻咽癌放、化疗配合颈淋巴结微波热疗,能显著提高颈淋巴结的完全消退率,减少淋巴结的局部放疗剂量,且5年颈淋巴结局控率明显优于单纯放化疗,并能明显提高患者的长期生存率.
목적 관찰비인암방、화료배합경부림파결미파열료적근기급원기료효.방법 154례초치N2～N3기비인암환자분위2조:대조조78례,5-불뇨밀정+순박연합화료,21 d위1주기,화료1～2주기후행상규방료,원발조방료제량DT70～78 Gy/35～39 f,47～51 d.경림파결전이조DT68～72 Gy/34～36 f,46～50 d;열료조76례,방、화료방법동대조조,경림파결우방료제1천개시배합국부미파열료,매차유효가온시간45 min,매주2차,공8～14차.결과 열료조화대조조적경림파결완전소퇴솔분별위80.3%화61.5%,차이유통계학의의(P<0.05),총유효솔분별위100%화96.2%.열료조여대조조적경림파결완전소퇴시적방료제량분별위(45.8±5.46)Gy화(58.8±5.03)Gy,차이유통계학의의(P<0.01).열료조여대조조적5년경림파결국공솔분별위97.4%화76.9%,차이유통계학의의(P<0.05).열료조여대조조1,3,5년생존솔분별위97.4%화93.6%(P>0.05)、76.3%화52.6%(P<0.01)、59.2%화41.0%(P<0.05).결론 대N2、N3기비인암방、화료배합경림파결미파열료,능현저제고경림파결적완전소퇴솔,감소림파결적국부방료제량,차5년경림파결국공솔명현우우단순방화료,병능명현제고환자적장기생존솔.
Objective To evaluate the short- and long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating metastatic nasopharyngeal carcinoma to the cervical lymph nodes. Methods A total of 154 cases of stage N2-N3 nasopharyngeal carcinoma (1992 stage system) were randomized into two groups: group A (76 cases, treated with microwave hyperthermia combined with chemoradiotherapy) and group B (78 ca-ses, treated with chemoradiotherapy alone). Both groups received 1 to 2 cycles of chemotherappy with cisplatin and 5-fluorouracil and then received regular radiotherapy. The total doses of radiotherapy were 70-78 Gy/35-39 f, 47-51 d for the primary loci of nasopharynx and 68-72 Gy/34-36 f,46-50 d for the metastatic loci in the neck. Group A received microwave hyperthermia on the metastatic cervical node at the beginning of radiotherapy, with the micro-wave hyperthermia administered for 45 min every time,two times a week, totaling 8 to 14 times. Results The complete extinction rates of neck metastatic carcinoma were 80.3% and 61.5% , respectively, in groups A and B (P<0.05). The overall response rates of neck metastasis in the two groups were 100% and 96.2% , respective-ly. When the cervical lymph node metastasis disappeared, the radiotherapy doses in group A and B were (45.8 ± 5.46 ) Gy and (58.8±5.03 ) Gy, respectively (P<0.01). The 5-year local control rates of cervical lymph node in group A and B were 97.4% and 76.9%(P<0.05 ), respectively. The one-, three- and five- year survival rates were 97.4% , 76.3% and 59.2% respectively, in group A, versus 93.6% (P>0.05) ; and 52.6% (P< 0.01) and 41.0% (P<0.05), respectively, in group B. Conclusions Microwave hyperthermia combined with chemoradiotherapy can elevate the complete extinction rate of cervical lymph node metastasis of nasopharyngeal carcinoma and reduce the radiotherapy dose needed of effective control. The 5-year local control rate of cervical lymph node metastasis in combined therapy group is superior to that in the chemoradiotherapy alone group,and can elevate the long-term survival rate of patients.