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[目的]观察单纯放疗和同期放化疗两种治疗方法对局部晚期鼻咽癌的临床疗效、毒副反应。[方法]将56例T3～4N3M0鼻咽癌病人随机分为单纯放疗组(对照组)和同期放化组(放化组)各28例。放疗:两组病人均使用常规分割外照射,使鼻咽部剂量达到70～78Gy,颈部剂量达到66～80Gy。化疗:放化组采用顺铂、氟尿嘧啶(5-Fu),1次/周,共用3～6个周期。[结果]对照组28例病人均按计划完成治疗,放化组中有6例病人因严重放化疗反应未能按计划完成。对照组和放化组3年生存率分别为71.42%、75.00%(P>0.05);3年远处转移率分别为28.57%、25.00%(P<0.05);3年累计复发率分别为14.28%、17.85%(P>0.05);3年无瘤生存率分别为67.85%、64.28%(P<0.05)。[结论]局部晚期鼻咽癌顺利完成同期放化疗的患者,远处转移率及无瘤生存率体现一定的优势。
[Objective] To observe the clinical curative effect and toxicity of both simple and concurrent chemoradiotherapy on locally advanced nasopharyngeal carcinoma. [Method] Fifty-six patients with T3 ~ 4N3M0 nasopharyngeal carcinoma were randomly divided into radiotherapy group (control group) and radiotherapy group (radiotherapy group), 28 cases in each group. Radiotherapy: The two groups of patients were treated with conventional external beam irradiation, the nasopharyngeal dose reached 70 ~ 78Gy, the neck dose reached 66 ~ 80Gy. Chemotherapy: radiotherapy group with cisplatin, fluorouracil (5-Fu), 1 / week, sharing 3 to 6 cycles. [Results] The control group of 28 patients completed the treatment according to plan, and 6 patients in the radiotherapy group failed to complete the program due to the serious radiotherapy and chemotherapy response. The 3-year survival rates in control and radiotherapy groups were 71.42% and 75.00% respectively (P> 0.05). The 3-year distant metastasis rates were 28.57% and 25.00% (P <0.05) respectively. The 3-year cumulative recurrence rates were 14.28 %, 17.85% respectively (P> 0.05). The 3-year disease-free survival rates were 67.85% and 64.28%, respectively (P <0.05). [Conclusion] The patients with locally advanced nasopharyngeal carcinoma successfully completed concurrent chemoradiotherapy, distant metastasis rate and tumor-free survival rate show some advantages.