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目的 比较超分割加同期化疗与单纯超分割放射治疗Ⅲ～Ⅳ期鼻咽癌的生存率和局部控制率。方法 15 0例鼻咽癌患者随机分入超分割加同期化疗组 (研究组 )和单纯超分割放射治疗组(对照组 )。放射治疗方式 2个组相同 ,1.2Gy/次 ,2次 /d。研究组在放射治疗前、中加用化疗 ,放射、化疗同期进行。结果 5年总生存率为 5 7.3% ,5年无瘤生存率和无远地转移生存率均为 5 5 .9%。研究组和对照组 5年生存率分别为 6 4.0 %和 5 0 .7% ,(χ2 =4.2 6 ,P =0 .0 37)。研究组有 1例鼻咽部复发而对照组有 5例鼻咽部复发 ,5年局部控制率分别为 98.7%和 93.4%。研究组的急性黏膜反应高于对照组 ,但能耐受 ,无严重并发症发生。结论 超分割放射同期化疗治疗Ⅲ～Ⅳ期鼻咽癌生存率和局部控制率有所提高 ,且能耐受。化疗对Ⅳ期的生存率影响更大。
Objective To compare the survival rate and local control rate of stage Ⅲ ~ Ⅳ nasopharyngeal carcinoma with superfractionated plus synchronous chemotherapy and simple hyperfractionated radiotherapy. Methods Fifty patients with nasopharyngeal carcinoma were randomly divided into hyperfractionated and concurrent chemotherapy group (study group) and pure hyperfractionated radiotherapy group (control group). Radiation therapy 2 groups the same, 1.2Gy / time, 2 times / d. The study group before radiotherapy, plus plus chemotherapy, radiation, chemotherapy over the same period. Results The 5-year overall survival rate was 7.33%. The 5-year disease-free survival rate and the distant metastasis-free survival rate were both 55.9%. The 5-year survival rates in study and control groups were 6 4.0% and 50.7%, respectively (χ2 = 4.2 6, P = 0.037). One case of nasopharyngeal recurrence in the study group and five cases of nasopharyngeal recurrence in the control group, the 5-year local control rates were 98.7% and 93.4%. The study group’s acute mucosal response than the control group, but can tolerate, no serious complications. Conclusion Survival rate and local control rate of stage Ⅲ ~ Ⅳ nasopharyngeal carcinoma treated by hyperfraction radiotherapy are improved and can be tolerated. Chemotherapy on the survival rate of Ⅳ greater impact.