CAJ | 학술논문

目的：比较IMRT联合化疗治疗局部晚期鼻咽癌临床疗效和不良反应。方法对2007-2010年间收治的符合入组标准的280例鼻咽癌患者随机均分为实验组和对照组,实验组采用同期放化疗和新辅助化疗方案治疗,对照组采用单纯放疗方案治疗。结果治疗后3年内复发24例(观察组5例,对照组19例)；远处转移19例(观察组4例,对照组15例),3年内死亡19例(全为对照组),两组患者差异有统计学意义(P<0.05)；治疗期间急性不良反应包括皮肤发射损伤及恶心呕吐50例(实验组35例,对照组15例),白细胞减少160例(实验组102例,对照组58例),两组患者差异有统计学意义(P<0.05)。治疗后1年主要不良反应为皮下软组织纤维化68例(实验组32例,对照组36例),放射性脑病8例(实验组3例,对照组5例),两组患者差异无统计学意义(P>0.05)。结论采用同期放化疗及新辅助化疗可显著提高局部晚期鼻咽癌患者的远期生存率,虽然急性不良反应发生率较单纯放疗高,但远期不良反应相近。
목적：비교IMRT연합화료치료국부만기비인암림상료효화불량반응。방법대2007-2010년간수치적부합입조표준적280례비인암환자수궤균분위실험조화대조조,실험조채용동기방화료화신보조화료방안치료,대조조채용단순방료방안치료。결과치료후3년내복발24례(관찰조5례,대조조19례)；원처전이19례(관찰조4례,대조조15례),3년내사망19례(전위대조조),량조환자차이유통계학의의(P<0.05)；치료기간급성불량반응포괄피부발사손상급악심구토50례(실험조35례,대조조15례),백세포감소160례(실험조102례,대조조58례),량조환자차이유통계학의의(P<0.05)。치료후1년주요불량반응위피하연조직섬유화68례(실험조32례,대조조36례),방사성뇌병8례(실험조3례,대조조5례),량조환자차이무통계학의의(P>0.05)。결론채용동기방화료급신보조화료가현저제고국부만기비인암환자적원기생존솔,수연급성불량반응발생솔교단순방료고,단원기불량반응상근。
Objective To observe and compare the clinical curative effect and adverse reactions of IMRT combined with chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma. Methods 280 patients with nasopharyngeal carcinoma who met the inclusion criteriain and admitted from 2007 to 2010 were randomly and equally divided into the experimental group and the control group. The experimental group was treated with concurrent chemoradiotherapy and neoadjuvant chemotherapy, while the control group was treated with radiation therapy. Results Within 3 years after treatment, there were 24 cases with recurrence (5 cases in the observation group, 19 cases in the control group);19 cases with distant metastasis (4 cases in the observation group, 15 cases in the control group), 19 cases died in these 3 years (all in the control group), the difference between the two groups was statistically significant (P<0.05); the acute adverse reactions during the treatment included 50 cases with radiation injury of skin and nausea and vomiting(35 cases in the experimental group, 15 cases in the control group), 160 cases with leucopenia (102 cases in the experimental group, 58 cases in the control group), the difference between the two groups was statistically significant (P<0.05). The adverse reactions 1 year after treatment mainly were 68 cases with subcutaneous soft tissue fibrosis (32 cases in the experimental group, 36 cases in the control group), 8 cases with radiation encephalopathy (3 cases in the experimental group, 5 cases in the control group), the difference between the two groups was not statistically significant (P>0.05). Conclusion For patients with locally advanced nasopharyngeal carcinoma, concurrent chemoradiotherapy and neoadjuvant chemotherapy can significantly improve the long-term survival rate, although the incidence of acute adverse reactions of which is higher than that of radiotherapy alone, the long-term adverse reactions of the two treatment methods are similar.