CAJ | 학술논문

目的：观察局部晚期鼻咽癌（N PC ）顺铂加5-氟尿嘧啶（PF ）诱导化疗后顺铂同步调强放疗（IMRT）与单纯顺铂同步IMRT的疗效和副反应。方法73例NPC随机分为A、B两组，A组PF诱导化疗1周期，顺铂20mg／m2，d1～5，5-Fu 500mg／m2，d1～5，然后顺铂同步IM RT ；B组单纯顺铂同步IM RT ，顺铂同步方法为40mg／m2，每周1次，共6次。评价两方案的近期疗效、1和2年总生存率（OS ）、无疾病进展生存率（FPS ）及副反应。结果 A、B组近期有效率分别为97．3％和97．2％；A组1、2年OS和FPS分别为100％和94．6％、97．3％和86．5％；B组1、2年OS和FPS分别为100％和91．7％、100％和83．3％，两组近期疗效和1、2年生存率无统计学差异。A组血液学毒性较B组明显。结论 PF诱导同步与单纯顺铂同步放疗方案的疗效相似，副反应可耐受，PF诱导方案不延长治疗时间。
목적：관찰국부만기비인암（N PC ）순박가5-불뇨밀정（PF ）유도화료후순박동보조강방료（IMRT）여단순순박동보IMRT적료효화부반응。방법73례NPC수궤분위A、B량조，A조PF유도화료1주기，순박20mg／m2，d1～5，5-Fu 500mg／m2，d1～5，연후순박동보IM RT ；B조단순순박동보IM RT ，순박동보방법위40mg／m2，매주1차，공6차。평개량방안적근기료효、1화2년총생존솔（OS ）、무질병진전생존솔（FPS ）급부반응。결과 A、B조근기유효솔분별위97．3％화97．2％；A조1、2년OS화FPS분별위100％화94．6％、97．3％화86．5％；B조1、2년OS화FPS분별위100％화91．7％、100％화83．3％，량조근기료효화1、2년생존솔무통계학차이。A조혈액학독성교B조명현。결론 PF유도동보여단순순박동보방료방안적료효상사，부반응가내수，PF유도방안불연장치료시간。
Objective To evaluate the efficacy and toxicity of induction chemotherapy of cisplatin plus 5-fluorouracil(PF)followed by concurrent chemoradiotherapy (CCRT )with cisplatin and intensity modulated radiotherapy(IMRT )versus CCRT with cisplatin alone and IMRT for locally advanced nasopharyngeal carcinoma(NPC) .Methods All 73 patients with NPC were enrolled randomly into A and B groups .Patients in A group received 1 cycle induction chemotherapy with PF (DDP 20mg/m2 ,d1~5 ,5-Fu 500mg/m2 ,d1~5)followed by CCRT with weekly cisplatin (40mg/m2 )for 6 weeks .Patients in B group were treated by IMRT with concurrent weekly cisplatin (40mg/m2 )for 6 weeks .Short-term efficacy ,1-,2-year overall survival rates (OS )and progression-free survival rates (FPS )and side-effects of the two regimens were investigated .Results The overall response rate in A and B groups were 97 .3% and 97 .2% ,respectively . The 1-,2-year OS and FPS in A group were 100% and 94 .6% ,97 .3% and 86 .5% ,respectively .In B group , the 1-,2-year OS and FPS were 100% and 91 .7% ,100% and 83 .3% ,respectively .No significant difference of efficacy was found between two groups ,but hematological toxicity was obvious in A group .Conclusion The efficacy of the two regimens is similar and toxicity is tolerable .PF regimen dose not prolong treatment time .