肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2012年
6期
405-409
,共5页
蔡凯%余昭胜%廖天华%胡奇友%谭长超
蔡凱%餘昭勝%廖天華%鬍奇友%譚長超
채개%여소성%료천화%호기우%담장초
鼻咽肿瘤%放射疗法%药物疗法,联合%预后
鼻嚥腫瘤%放射療法%藥物療法,聯閤%預後
비인종류%방사요법%약물요법,연합%예후
Nasopharyngeal neoplasms%Radiotherapy%Drug therapy,combination%Prognosis
目的 探讨同期放化疗联合辅助化疗对鼻咽癌高发区人群的疗效及不良反应情况.方法 2006年1月至2010年6月入组141例鼻咽癌患者,随机数字表法分为同期放化疗联合辅助化疗组(70例)和同期放化疗组(71例).两组均采用二维精确放射治疗和2个疗程顺铂、5-氟尿嘧啶(5-Fu)同步化疗；同期放化疗联合辅助化疗组在放疗结束后3周开始3个疗程顺铂、5-Fu辅助化疗.结果 所有入组患者均按计划完成同期放化疗,同期放化疗联合辅助化疗组有63例完成辅助化疗.两组同步放化疗期和同期放化疗联合辅助化疗组辅助化疗期主要不良反应有黏膜炎、白细胞减少、血小板减少和胃肠道反应,两组比较差异无统计学意义.放疗结束后3个月,同期放化疗联合辅助化疗组和同期放化疗组鼻咽部、颈部淋巴结肿瘤消退率分别为94.4％(67/70)和87.3％(62/71).中位随访36个月.同期放化疗联合辅助化疗组1、2、3年总生存率分别为94.3％、84.8％、78.6％,中位生存期为36个月,同期放化疗组分别为90.1％、75.0％、62.5％,中位生存期为27个月,两组比较差异有统计学意义(x2=7.356,P=0.007).同期放化疗联合辅助化疗组Ⅲ期患者1、2、3年总生存率分别为98.2％、92.5％、83.7％,同期放化疗组分别为93.0％、83.2％、68.2％,中位生存时间均为36个月；两组比较差异有统计学意义(x 2=8.081,P=0.005).同期放化疗联合辅助化疗组Ⅳ期患者1、2、3年总生存率分别为81.3％、53.8％、42.9％,同期放化疗组分别为78.6％、36.4％、22.3％,中位生存时间分别为22个月和14个月,两组比较差异有统计学意义(x2=3.903,P=0.048).同期放化疗联合辅助化疗组1、2、3年无进展生存率分别为90.0％、76.2％、68.8％,同期放化疗组分别为81.7％、60.3％、34.3％,中位无进展生存时间分别为30个月和22个月,两组比较差异有统计学意义(x 2=13.616,P=0.000).结论 对鼻咽癌高发区Ⅲ、Ⅳ期鼻咽癌患者,该同期放化疗联合辅助化疗方案依从性较高,不良反应相对较低,可提高总生存率及无进展生存率.
目的 探討同期放化療聯閤輔助化療對鼻嚥癌高髮區人群的療效及不良反應情況.方法 2006年1月至2010年6月入組141例鼻嚥癌患者,隨機數字錶法分為同期放化療聯閤輔助化療組(70例)和同期放化療組(71例).兩組均採用二維精確放射治療和2箇療程順鉑、5-氟尿嘧啶(5-Fu)同步化療；同期放化療聯閤輔助化療組在放療結束後3週開始3箇療程順鉑、5-Fu輔助化療.結果 所有入組患者均按計劃完成同期放化療,同期放化療聯閤輔助化療組有63例完成輔助化療.兩組同步放化療期和同期放化療聯閤輔助化療組輔助化療期主要不良反應有黏膜炎、白細胞減少、血小闆減少和胃腸道反應,兩組比較差異無統計學意義.放療結束後3箇月,同期放化療聯閤輔助化療組和同期放化療組鼻嚥部、頸部淋巴結腫瘤消退率分彆為94.4％(67/70)和87.3％(62/71).中位隨訪36箇月.同期放化療聯閤輔助化療組1、2、3年總生存率分彆為94.3％、84.8％、78.6％,中位生存期為36箇月,同期放化療組分彆為90.1％、75.0％、62.5％,中位生存期為27箇月,兩組比較差異有統計學意義(x2=7.356,P=0.007).同期放化療聯閤輔助化療組Ⅲ期患者1、2、3年總生存率分彆為98.2％、92.5％、83.7％,同期放化療組分彆為93.0％、83.2％、68.2％,中位生存時間均為36箇月；兩組比較差異有統計學意義(x 2=8.081,P=0.005).同期放化療聯閤輔助化療組Ⅳ期患者1、2、3年總生存率分彆為81.3％、53.8％、42.9％,同期放化療組分彆為78.6％、36.4％、22.3％,中位生存時間分彆為22箇月和14箇月,兩組比較差異有統計學意義(x2=3.903,P=0.048).同期放化療聯閤輔助化療組1、2、3年無進展生存率分彆為90.0％、76.2％、68.8％,同期放化療組分彆為81.7％、60.3％、34.3％,中位無進展生存時間分彆為30箇月和22箇月,兩組比較差異有統計學意義(x 2=13.616,P=0.000).結論 對鼻嚥癌高髮區Ⅲ、Ⅳ期鼻嚥癌患者,該同期放化療聯閤輔助化療方案依從性較高,不良反應相對較低,可提高總生存率及無進展生存率.
목적 탐토동기방화료연합보조화료대비인암고발구인군적료효급불량반응정황.방법 2006년1월지2010년6월입조141례비인암환자,수궤수자표법분위동기방화료연합보조화료조(70례)화동기방화료조(71례).량조균채용이유정학방사치료화2개료정순박、5-불뇨밀정(5-Fu)동보화료；동기방화료연합보조화료조재방료결속후3주개시3개료정순박、5-Fu보조화료.결과 소유입조환자균안계화완성동기방화료,동기방화료연합보조화료조유63례완성보조화료.량조동보방화료기화동기방화료연합보조화료조보조화료기주요불량반응유점막염、백세포감소、혈소판감소화위장도반응,량조비교차이무통계학의의.방료결속후3개월,동기방화료연합보조화료조화동기방화료조비인부、경부림파결종류소퇴솔분별위94.4％(67/70)화87.3％(62/71).중위수방36개월.동기방화료연합보조화료조1、2、3년총생존솔분별위94.3％、84.8％、78.6％,중위생존기위36개월,동기방화료조분별위90.1％、75.0％、62.5％,중위생존기위27개월,량조비교차이유통계학의의(x2=7.356,P=0.007).동기방화료연합보조화료조Ⅲ기환자1、2、3년총생존솔분별위98.2％、92.5％、83.7％,동기방화료조분별위93.0％、83.2％、68.2％,중위생존시간균위36개월；량조비교차이유통계학의의(x 2=8.081,P=0.005).동기방화료연합보조화료조Ⅳ기환자1、2、3년총생존솔분별위81.3％、53.8％、42.9％,동기방화료조분별위78.6％、36.4％、22.3％,중위생존시간분별위22개월화14개월,량조비교차이유통계학의의(x2=3.903,P=0.048).동기방화료연합보조화료조1、2、3년무진전생존솔분별위90.0％、76.2％、68.8％,동기방화료조분별위81.7％、60.3％、34.3％,중위무진전생존시간분별위30개월화22개월,량조비교차이유통계학의의(x 2=13.616,P=0.000).결론 대비인암고발구Ⅲ、Ⅳ기비인암환자,해동기방화료연합보조화료방안의종성교고,불량반응상대교저,가제고총생존솔급무진전생존솔.
Objective To investigate the effects and toxic side effects of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy in nasopharyngeal carcinoma.Methods 141 patients of nasopharyngeal carcinoma divided into two groups randomly.All patients treated two-dimension exact radiotherapy and concurrent chemotherapy which combined DDP and 5-Fu intravenously for two circles,then experiment group started adjuvant chemotherapy 3 weeks later after above treatment,which intravenous DDP and 5-Fu for other three circles.Results All patients completed concurrent radiotherapy and chemotherapy,63 patients of treatment group completed adjuvant chemotherapy.The mainly toxic side effect was mucositis,leukopenia and low-platelet,and gastrointestinal reaction during therapy,there is no statistical significance in two groups.The regression rate of lymph nodes is 94.4 ％(n=67)and 87.3 ％(n=62)in nasopharynx and neck after 3 month of radiotherapy and concurrent chemotherapy.All patients followed up 3 years.The total survival rate of two groups were 94.3 ％,84.8 ％,78.6 ％ and 90.1％,75.0 ％,62.5 ％ respectly in 1,2 and 3 year,the mean survival period was 36 months and 27 months,and this differece was statistical significance(x2=7.356,P=0.007).The total survival rate of Ⅲ stage patients of two groups were 98.2 ％,92.5 ％,83.7 ％ and 93.0 ％,83.2 ％,68.2 ％ respectly in 1,2 and 3 year,the both mean survival period was 36 months,and this differece was statistical significance(x2=8.081,P=0.005).The total survival rate of Ⅳ stage patients of two groups were 81.3 ％、53.8 ％、42.9 ％ and 78.6 ％、36.4 ％ 、22.3 ％ respectly in 1,2 and 3 year,the meat survival period were 22 month and 14 month respectly,and this differece was statistical significance(x2=3.903,P=0.048).The progression-free survival rate of two groups were 90.0 ％、76.2 ％、68.8 ％,and 81.7 ％、60.3 ％、34.3 ％ respectly in 1,2 and 3 year,the meat progression-free survival period was 30months and 22months,and this differece was statistical significance as well(x2=13.616,P=0.000).Conclusion The therapy of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy was obviously increased total survival rate and progression-free survival rate in nasopharyngeal carcinoma,especially to Ⅲ and Ⅳ stage patient of nasopharyngeal carcinoma.But the long period effects still remains unclear.
