医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2014年
3期
47-48
,共2页
赵彩霞%胡欣%潘荣强%陈思林%李婷婷
趙綵霞%鬍訢%潘榮彊%陳思林%李婷婷
조채하%호흔%반영강%진사림%리정정
鼻咽癌%放疗%化疗%奈达铂%同期
鼻嚥癌%放療%化療%奈達鉑%同期
비인암%방료%화료%내체박%동기
Nasopharyngeal carcinoma (NPC)%Radiotherapy%Chemotherapy%Nedaplatin%Concurrent
目的：探讨放疗联合奈达铂周同步化疗治疗中晚期鼻咽癌的疗效。方法收集病理证实为鳞癌的局部中晚期鼻咽癌（T3-4期）153例的临床资料，其中72例行单纯放疗（简称单放组），81例行放疗联合奈达铂周同步化疗（简称联合组）。放疗方法相同：开始采用面颈联合野和下半颈切线野常规分割，DT36Gy后鼻咽部采用适形放射治疗和全颈切线野放疗，鼻咽部剂量70~72Gy，颈部淋巴结阳性者剂量65~70Gy，淋巴结阴性者剂量60~65Gy。联合组在放疗同时每周同步给予奈达铂化疗。结果治疗结束后第6、12个月，鼻咽部原发灶完全缓解率（CR）：单放组为分别为70.83%(51/72)、56.94%(41/72)，联合组分别为85.16%(69/81)、80.25%(65/81)， P＜0.05；治疗结束后第6、12个月颈部淋巴结完全缓解率(CR)：单放组分别为为79.03%(49/62)、69.35%(43/62)，联合组分别为92.75%(64/69)、86.96%(60/69)，P＜0.05；单放组和联合组1、2、3年生存率分别为80.56%(58/72)、70.83%(51/72)、44.45%(32/72)和93.83%(76/81)、86.42%(70/81)、80.25%(65/81)，P＜0.05。不良反应轻，经对症处理后均能完成放化疗。结论放疗联合周同步奈达铂化疗治疗中晚期鼻咽癌疗效较好，不良反应较少，患者耐受性好。
目的：探討放療聯閤奈達鉑週同步化療治療中晚期鼻嚥癌的療效。方法收集病理證實為鱗癌的跼部中晚期鼻嚥癌（T3-4期）153例的臨床資料，其中72例行單純放療（簡稱單放組），81例行放療聯閤奈達鉑週同步化療（簡稱聯閤組）。放療方法相同：開始採用麵頸聯閤野和下半頸切線野常規分割，DT36Gy後鼻嚥部採用適形放射治療和全頸切線野放療，鼻嚥部劑量70~72Gy，頸部淋巴結暘性者劑量65~70Gy，淋巴結陰性者劑量60~65Gy。聯閤組在放療同時每週同步給予奈達鉑化療。結果治療結束後第6、12箇月，鼻嚥部原髮竈完全緩解率（CR）：單放組為分彆為70.83%(51/72)、56.94%(41/72)，聯閤組分彆為85.16%(69/81)、80.25%(65/81)， P＜0.05；治療結束後第6、12箇月頸部淋巴結完全緩解率(CR)：單放組分彆為為79.03%(49/62)、69.35%(43/62)，聯閤組分彆為92.75%(64/69)、86.96%(60/69)，P＜0.05；單放組和聯閤組1、2、3年生存率分彆為80.56%(58/72)、70.83%(51/72)、44.45%(32/72)和93.83%(76/81)、86.42%(70/81)、80.25%(65/81)，P＜0.05。不良反應輕，經對癥處理後均能完成放化療。結論放療聯閤週同步奈達鉑化療治療中晚期鼻嚥癌療效較好，不良反應較少，患者耐受性好。
목적：탐토방료연합내체박주동보화료치료중만기비인암적료효。방법수집병리증실위린암적국부중만기비인암（T3-4기）153례적림상자료，기중72례행단순방료（간칭단방조），81례행방료연합내체박주동보화료（간칭연합조）。방료방법상동：개시채용면경연합야화하반경절선야상규분할，DT36Gy후비인부채용괄형방사치료화전경절선야방료，비인부제량70~72Gy，경부림파결양성자제량65~70Gy，림파결음성자제량60~65Gy。연합조재방료동시매주동보급여내체박화료。결과치료결속후제6、12개월，비인부원발조완전완해솔（CR）：단방조위분별위70.83%(51/72)、56.94%(41/72)，연합조분별위85.16%(69/81)、80.25%(65/81)， P＜0.05；치료결속후제6、12개월경부림파결완전완해솔(CR)：단방조분별위위79.03%(49/62)、69.35%(43/62)，연합조분별위92.75%(64/69)、86.96%(60/69)，P＜0.05；단방조화연합조1、2、3년생존솔분별위80.56%(58/72)、70.83%(51/72)、44.45%(32/72)화93.83%(76/81)、86.42%(70/81)、80.25%(65/81)，P＜0.05。불량반응경，경대증처리후균능완성방화료。결론방료연합주동보내체박화료치료중만기비인암료효교호，불량반응교소，환자내수성호。
Objective: To investigate therapeutic ef ect of radiotherapy combining weekly concurrent chemotherapy with nedaplatin to treat advanced nasopharyngeal carcinoma (NPC). Methods: The data of 153 patients with advanced T-stage (T3-4) NPC confirmed by pathology was col ected. 72 cases were suf ered with radiotherapy alone (RT Group). 81 cases were suf ered with radiotherapy combining weekly concurrent chemotherapy with nedaplatin (CRT Group). Identical radiotherapy mode was adopted to al cases. The first period radiotherapy were administered DT36Gy with conventional face neck combining field and hypo-neck tangential field. Fol owing, al the patients were administered DT70-72Gy with conformal therapy in pharynx nasalis, and neck tangential field radiotherapy DT65-70Gy to positive neck lymph node, DT60-65Gy to negative lymph node. CRT Group was suf ered radiotherapy combining weekly concurrent chemotherapy with nedaplatin. Results: After 6, 12months of treatment, the complete response (CR) rate of the pharynx nasalis focus of infection in RT group was 70.83%(51/72) and 56.94%(41/72), it was 85.16%(69/81) and 80.25%(65/81) in CRT group, respectively, P<0.05. The CR rate of neck lymph node in RT group was 79.03%(49/62) and 69.35%(43/62), it was 92.75%(64/69) and 86.96%(60/69) in CRT group, respectively, P<0.05. Survival rate of 1, 2, 3 years in CR group and CRT group were 0.56%(58/72), 70.83%(51/72), 44.45%(32/72) and 93.83%(76/81), 86.42%(70/81), 80.25% (65/81), respectively, P<0.05. The adverse reaction was regarded slightly. Conclusions: Radiotherapy combining weekly concurrent chemotherapy with nedaplatin to treat advanced nasopharyngeal carcinoma (NPC) was regarded bet er therapeutic ef ect than alone radiotherapy. And toxicity reactions could be tolerant.
