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目的 比较诱导化疗加放疗与单纯放疗治疗晚期鼻咽癌的疗效。方法 将 78例Ⅲ、Ⅳa期鼻咽癌随机分为 2组 ,每组 3 9例。治疗组 (A组 )诱导化疗 2个疗程后再行放疗 (化疗方案 :卡铂 3 0 0mg/m2 ,静脉滴注 ,第 1天 ;5 Fu 5 0 0mg/m2 ,静脉滴注 ,第 1～ 3天 ;平阳霉素 16mg/m2 ,静脉滴注 ,第 1天 ) ;对照组 (B组 )单纯放疗。结果 诱导化疗后鼻咽癌病灶及颈淋巴结有效率(CR +PR )分别为 5 3 .8% (2 1/3 9)、72 .7% (2 4/3 3 )。A、B组 5年总生存率及无瘤生存率分别为 43 .6%、40 .8% ,3 8.4%、3 4.0 % (P>0 .0 5 ) ;远处转移率A、B组分别为 3 8.5 %、41.0 % ;2组远期严重并发症发生率相近。结论 诱导化疗加放疗不能提高晚期鼻咽癌患者的生存率 ,也不能降低其远处转移率。
Objective To compare the efficacy of induction chemotherapy plus radiotherapy and radiotherapy alone in the treatment of advanced nasopharyngeal carcinoma. Methods Seventy-eight patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma were randomly divided into two groups (39 cases in each group). The patients in the treatment group (group A) received radiotherapy after induction of chemotherapy for 2 courses (chemotherapy regimen: carboplatin 300 mg / m2, intravenous drip on day 1, 5 Fu5 0 0 mg / m2, intravenous drip, 3 days; Pingyangmycin 16mg / m2, intravenous drip, day 1); control group (group B) radiotherapy alone. Results The effective rates (CR + PR) of nasopharyngeal carcinoma lesions and cervical lymph nodes after induction chemotherapy were 53.8% (2 1/3 9) and 72.7% (2 4/3 3), respectively. The 5-year overall survival rate and tumor-free survival rate in group A and B were 43.6%, 40.8%, 34.4% and 34.0% respectively (P> 0.05). The distant metastasis rates in groups A and B Respectively, 8.5%, 41.0%; two groups of long-term serious complications were similar. Conclusion Induction chemotherapy plus radiotherapy can not improve the survival rate of patients with advanced nasopharyngeal carcinoma, nor can it reduce the distant metastasis rate.