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目的研究紫杉醇加顺铂方案(TP)新辅助化疗联合放疗治疗晚期鼻咽癌的临床疗效。方法1998年1月至2001年1月57例病理确诊为鼻咽癌,根据福州1992年分期标准,57例均为Ⅲ、Ⅳa期的初治患者,随机分为综合组27例,单放组30例。综合组行TP方案新辅助化疗2个疗程后放疗。结果综合组与单放组鼻咽全消率分别为96.3%和83.0%(P<0.05),颈部淋巴结全消率分别为100%和93.3%(P>0.05)。综合组胃肠道反应、口腔黏膜反应、皮肤反应及白细胞减少等毒副反应均强于单放组,但差异无显著性(P>0.05)。综合组5年生存率(59.3%)与单放组(43.3%)相比差异无显著性(P>0.05)。结论TP方案新辅助化疗联合放疗可提高肿瘤局控率,未能提高晚期鼻咽癌生存率。
Objective To study the clinical efficacy of paclitaxel plus cisplatin (TP) neoadjuvant chemotherapy combined with radiotherapy in the treatment of advanced nasopharyngeal carcinoma. Methods From January 1998 to January 2001, 57 cases were diagnosed as nasopharyngeal carcinoma by pathology. According to the Fuzhou 1992 staging system, 57 patients with newly diagnosed stage Ⅲ and Ⅳa were randomly divided into two groups: 27 cases in combination group, 30 cases. Integrated group TP program neoadjuvant chemotherapy after 2 courses of radiotherapy. Results The total elimination rate of nasopharyngeal in the combination group and the single group was 96.3% and 83.0% respectively (P <0.05). The complete elimination rate of cervical lymph nodes was 100% and 93.3% respectively (P> 0.05). The gastrointestinal tract reactions, oral mucosal reactions, skin reactions and leukopenia in the combination group were stronger than those in the single group, but the difference was not significant (P> 0.05). The 5-year overall survival rate (59.3%) in the combined group was not significantly different from that in the single group (43.3%) (P> 0.05). Conclusion TP regimen neoadjuvant chemotherapy combined with radiotherapy can increase the rate of tumor control, failed to improve the survival rate of advanced nasopharyngeal carcinoma.