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[目的]探讨新辅助化疗联合同步放化疗治疗中晚期鼻咽癌的临床疗效。[方法]2001年1月～2004年8月,85例中晚期鼻咽癌患者应用紫杉醇、DDP、5-Fu新辅助化疗2个疗程,采用DDP单药同步放化疗,放疗先采用面颈联合野加下颈部切线野,然后鼻咽原发灶改用面前野加耳前野,颈部改用电子线野加量,所有患者都接受根治剂量放疗,观察治疗疗效和耐受性。[结果]放疗结束后3个月鼻咽部CR84.7%,PR15.3%;颈部淋巴结CR91.2%,PR8.8%。1、3、5年生存率和无进展生存率分别为91.7%和90.6%、77.4%和70.6%、55.1%和50.2%。早期毒副反应主要是骨髓抑制和口腔黏膜炎;晚期主要是口干和颈部肌肉纤维化,患者均可耐受。[结论]新辅助化疗联合同步放化疗治疗中晚期鼻咽癌疗效好,毒副反应少,患者可耐受,适合中晚期鼻咽癌的治疗。
[Objective] To investigate the clinical effect of neoadjuvant chemotherapy combined with concurrent chemoradiotherapy on advanced nasopharyngeal carcinoma. [Methods] From January 2001 to August 2004, 85 patients with advanced nasopharyngeal carcinoma were treated with paclitaxel, DDP and 5-Fu neoadjuvant chemotherapy for 2 courses. Wild plus neck tangential field, and then use the former nasopharyngeal wild boar anterior field, neck to electronic field plus dose, all patients received radical dose radiotherapy to observe the efficacy and tolerability of treatment. [Results] Nasopharyngeal CR84.7%, PR15.3% at 3 months after radiotherapy; neck lymph nodes CR91.2%, PR8.8%. The 1-, 3-, 5-year and progression-free survival rates were 91.7% and 90.6%, 77.4% and 70.6%, 55.1% and 50.2% respectively. Early toxic side effects are mainly myelosuppression and oral mucositis; late mainly dry mouth and neck muscle fibrosis, patients can tolerate. [Conclusion] Neoadjuvant chemotherapy combined with concurrent chemoradiotherapy has good curative effect on nasopharyngeal carcinoma in the advanced stage, less toxic and side effects, and tolerable in patients. It is suitable for the treatment of advanced nasopharyngeal carcinoma.