关键词：鼻咽癌；放疗；化疗
摘要 目的： 探讨中晚期鼻咽癌放疗后加定期化疗的远期疗效。方法： 184例中晚期鼻咽癌病人中，91例放疗后定期化疗(放化组)，93例放疗前先化疗(化放组)，放疗:用60 Co加深部X线照射鼻咽、颅底和颈部三个区域，鼻咽剂量70～76Gy，颈部根治量65～70 Gy，残留病灶追加10 Gy。化疗：放化组放疗后用顺铂(DDP)加5-氟脲嘧啶(5-Fu)方案(PF方案)化疗2～6疗程；化放组放疗前先用PF方案化疗1～2疗程。结果： 5年生存率放化组59.3%，化放组40.9%。鼻咽肿瘤局控率放化组82.4%，化放组65.6%。颈淋巴结局控率放化组78%，化放组59.1%。远处转移率放化组9%，化放组38.7%，均有显著性差异(P<0.05)。结论： 中晚期鼻咽癌放疗后用DDP加5-Fu定期化疗，可减少局部复发和远处转移，提高生存率。
中国图书资料分类法分类号 R739.63
STUDY OF THERAPEUTIC EFFECTS OF RADIO-CHEMO THERAPY AND CHEMO-RADIO THERAPY FOR ADVANCD NPC
Lu Kunshi
Department of Radiotherapy,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021
Abstract Objective: To evaluate the longtime therapeutic effects of regular conbinated chemotherapy nasopharyngeal carcinoma (NPC)that is treated with radiotherapy.Methods: 184 cases of NPC were giventreatment with this scheme.Among them,91 cases recived regular chemotherapy afterradiotherapy (RT+CT group),and ninety three cases were recieved chemotherapy (CT+RT group)before radiotherepy.The nasopharynx,base skull of brain and cervical ragional were givenradiotherapy using 60 Co and deep-X ray.The total tumor dose of nasopharynx werefrom 70Gy to 76Gy,cervical radical dose were from 65Gy to 70Gy.If the tumor occuredresidually,additional 10Gy was given.The RT+CT group recieved chemotherapy form two to sixcourses with DDP+5-Fu;CT+RT group received one to two courses.Results: Thefive years suvival rate was 59.3% in RT+CT group,while CT+RT group 40.9%.Thenasopharyngeal tumor local cotrol rate was 82.4% in RT+CT group,CT+RT group were 65.6%.Theneck lymph node local cotrol rate was 78% in RT+CT group,and in CT+RT group 59.1%,thedistant metastases rate was 9% in RT+CT group,and in CT+RT group was 38.7%.The relapserates of the two groups were significanly different (P<0.05).Conclusion: Theseresults suggest that if after NPC was treated with radiotherapy,additional regularchemotherapy of DDP+5-Fu was applied.after radiotherapy of NPC addition regularchemotherapy with DDP+5-Fu,the local region relapse and distant matastasis woulddecrease,which could enhance the NPC patients survival rate.
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