摘要
目的观察鼻咽癌后程三维适形放疗加时间调节化疗与常规放化疗的疗效和副作用。方法将86例患者用信封法随机分为后程三维适形放疗加时间调节化疗组(CCR组)和常规放化疗组(RCR组)。两组均先进行2个周期顺铂+氟尿嘧啶+亚叶酸钙不同给药方法的诱导化疗,之后加不同方式的放疗。RCR组用药量同CCR组,鼻咽病灶放疗剂量均为70Gy7周。结果完全缓解率、有效率CCR组和RCR组分别为45.5%、95.5%和23.8%、71.4%。两组差异有统计学意义(P<0.05)。两组1、3年生存率差异无统计学意义(P>0.05)。RCR组相对于CCR组口腔炎、恶心呕吐、腹泻更多见(P<0.05),骨髓毒性反应的差异亦有统计学意义(P<0.05)。结论鼻咽癌后程三维适形放疗加时间调节化疗治疗较常规放化疗有较好效果,且副反应较低。
Objective To compare the therapeutic effects,toxic side effects of late-course three dimensional conformal radiotherapy plus chrono-chemotherapy(DDP+5-FU/CF) and conventional radiotherapy plus chemotherapy for nasopharyngeal carcinoma (NPC). Methods Eighty-six NPC patients admitted from Feb. 2001 to Jan. 2002 were divided randomly into two groups:1.Chrono-chemotherapy + late course three dimensional conformal radiotherapy(CCR) group—44 patients were treated by late course three dimensional conformal radiotherapy plus chrono-chemotherapy, and 2.Routine-chemotherapy-radiotherapy (RCR) group—42 patients were treated by routine chemotherapy plus radiotherapy. The patients in CCR and RCR group were comparable in age, KPS, stage and pathology. All patients were treated by combined chemotherapy and radiotherapy, with chemotherapy stared 2 weeks ahead of radiotherapy. Chemotherapy: Braun pump was used in all drug infusions;1.CCR group—DDP 80?mg/m2 starting from 10:00 until 22:00,5-Fu 750?mg/d/m2 starting from 22:00 until 10:00 next day, CF 200?mg/d/m2 starting from 10:00 every day, infused at normal speed. These drugs were given for 3 days, 14 days as one cycle, totally 2 cycle, and 2.RCR group—with the same drugs at the same total dose, only with the difference being DDP and CF given QD, starting from 10:00 but at the normal speed. 5-Fu was given throughout the day and continuously for 3 days, totally for 2 cycles. Radiotherapy: linear accelerator irradiation was given to either group. Composite facio-cervical field + anterior cervical tangential field to D_T 40?Gy/4w, followed by the coned down per-auricular field plus anterior tangential field or βbeam irradiation. In CCR group, after D_T 40gy/4w, late course 3-dimensional conformal radiotherapy(3DCRT) was used to add D_T 30?Gy/3w. In RCR group, routine radiotherapy of 40?Gy/w was supplemented with 30?Gy/3w. The total dose in either group was 70?Gy/7w at the nasopharynx, D_T60-70?Gy/6-7w at the neck, as cure while 50?Gy/5w for prophylaxis. Results The CR and PR of the CCR group was 45.5% and 95.5%, while the CR and PR of RCR group was 23.8% and 71.4% respectively. There was significant difference between the two groups in CR and PR (P<0.05). Higher incidence of stomatitis, nausea, vomiting, diarrhea, and bone marrow suppression was found in the RCR group than in the CCR group (P<0.05). Conclusion Late-course three dimensional conformal radiotherapy plus chrono-chemotherapy (DDP+5-FU/CF) is more favorable in the treatment of NPC with milder toxicity and side effects. Long term results will have to wait for further study.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2005年第4期269-272,共4页
Chinese Journal of Radiation Oncology
