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目的观察草酸铂联合氟脲嘧啶及醛氢叶酸同步化放疗治疗局部晚期鼻咽癌的疗效及毒副反应,探讨该方案的临床可行性。方法36例T3~4N2~3M0局部晚期鼻咽癌患者进入综合治疗组,分别在放疗第1、22、43 d接受草酸铂130mg/m2+5-氟脲嘧啶3.75mg/m2+醛氢叶酸100mg/m2同步化疗。选取32例单纯放疗者为对照组。结果所有病例如期完成治疗。放疗40Gy时,综合组颈淋巴结有效率较高(P<0.05);放疗结束5~6周后,综合组颈淋巴结完全缓解率较单纯放疗组明显提高(P<0.05);鼻咽肿瘤缓解率也有所提高,但无统计学意义(P>0.05)。毒性反应主要表现综合组比单纯放疗组更多发生Ⅰ、Ⅱ级骨髓抑制、胃肠道反应、脱发和周围神经炎;两组所发生的皮肤及黏膜反应相当。结论草酸铂联合氟脲嘧啶及醛氢叶酸同步化放疗,可明显提高晚期鼻咽癌患者颈淋巴结转移灶局控率,对鼻咽原发灶的控制也有一定帮助;对其毒性反应患者可耐受,未影响放疗的顺利完成。
Objective To observe the curative effect and side effects of oxaliplatin combined with fluorouracil and alformin simultaneous radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC), and to explore the clinical feasibility of this regimen. Methods Thirty-six patients with T3 ~ 4N2 ~ 3M0 local advanced nasopharyngeal carcinoma (NPC) were enrolled in the comprehensive treatment group and received oxaliplatin 130mg / m2 + 5-fluorouracil 3.75mg / m2 + m2 simultaneous chemotherapy. 32 cases of radiotherapy alone as the control group. Results All cases completed treatment on schedule. Radiotherapy 40Gy, the comprehensive group of cervical lymph node response rate was higher (P <0.05); 5 to 6 weeks after the end of radiotherapy, the comprehensive group of cervical lymph node complete remission rate was significantly higher than the radiotherapy group (P <0.05); nasopharyngeal tumor remission rate Also increased, but not statistically significant (P> 0.05). Toxicity mainly in the composite group than the radiotherapy group occurred more grade Ⅰ, Ⅱ myelosuppression, gastrointestinal reactions, hair loss and peripheral neuritis; skin and mucosal reactions occurred in both groups were comparable. Conclusions The combination of oxaliplatin combined with fluorouracil and alformin simultaneous radiotherapy can significantly improve the control rate of cervical lymph node metastasis in patients with advanced nasopharyngeal carcinoma and may be helpful in the control of primary nasopharyngeal carcinoma. By, did not affect the successful completion of radiotherapy.