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目的观察局部晚期下咽癌患者单纯放疗及同步放化疗的临床疗效。方法单放组:所有患者均采取靶区直线加速器适型调强放射治疗放疗,应用6MV射线,肿瘤单次剂量2Gy/次,1次/d,5次/周,共30次,总量60cGy;对于放射野外淋巴结,在总量60cGY后,采用9MEV电子线照射。放化组:放疗方法同上;化疗方法:在放疗第4周开始化疗,予DF方案:5-FU 0.50g/d,d1~5d(应用化疗泵持续泵入,共120h),奈达铂:20mg/d,d1~5d,同步给予控制副作用药物。结果本研究显示在两组患者中,单放组1、3年生存率分别为:45.0%和12.0%,而后期同步放化疗组1、3年生存率分别为81.8%和54.5%,两组1、3年生存率差异显著;而本研究中,同步放化疗急性毒性反应较单纯放疗大。结论采用后期同步放化疗的方法治疗局部晚期下咽癌较为适宜。
Objective To observe the clinical efficacy of radiotherapy alone and concurrent chemoradiotherapy in patients with locally advanced hypopharyngeal carcinoma. Methods All patients were treated with target-area linear accelerator with intensity-modulated radiation therapy. The tumors were exposed to 6MV radiation for a single dose of 2Gy / time, once / d for 5 times / week for 30 times with a total of 60cGy For the radiation of wild lymph nodes, the total dose of 60cGY, using 9MEV electron beam irradiation. Radiotherapy was given as above. Chemotherapy: Chemotherapy was started in the fourth week of radiotherapy. The DF regimen: 5-FU 0.50g / d, d1-5d (continuous infusion of chemotherapy pump for 120h), nedaplatin: 20mg / d, d1 ~ 5d, simultaneous control of side effects of drugs. Results In this study, the 1-year and 3-year survival rates were 45.0% and 12.0% respectively in the two groups, while the 1- and 3-year survival rates were 81.8% and 54.5% in the concurrent chemoradiation group. The two groups The 1-year and 3-year survival rates were significantly different. In this study, the acute toxicity of concurrent chemoradiotherapy was greater than that of radiotherapy alone. Conclusions The late concurrent chemoradiotherapy is more suitable for the treatment of locally advanced hypopharyngeal carcinoma.