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目的:探讨Ⅲ～Ⅳa期鼻咽癌患者放疗后辅助性化疗及顺铂同期放化疗疗效及预后比较。方法:收治病理确诊的Ⅲ～Ⅳa期鼻咽癌患者114例,综合患者情况,分别采用放疗加辅助性化疗、顺铂同期放化疗,其中放疗采用常规鼻咽癌根治性放疗技术,鼻咽肿瘤量68～74Gy/34～37次,全颈预防剂量52Gy/26次,颈部阳性淋巴结肿瘤量64～68Gy/32～34次,辅助性化疗为PF方案2～4疗程,同期化疗为顺铂(Cisplatin)30mg/次/周×7方案。结果:114例患者均按计划完成全程放疗,PF辅助性化疗2～4程,或同期接受顺铂化疗30mg/次/周。结果:所有患者近期完全缓解率为100%,中位2年随访,辅助性化疗组患者4例出现局部复发,12例出现远处转移,同期放化疗组患者无1例局部复发,9例出现远处转移,两组相比,同期放化疗组患者具有更高治愈率,差别具有统计学意义。结论:Ⅲ～Ⅳa期鼻咽癌患者行同期放化疗较放疗加辅助性化疗具有更高的治愈率。
Objective: To investigate the efficacy and prognosis of adjuvant chemotherapy and concurrent chemoradiotherapy with cisplatin in patients with stage Ⅲ-Ⅳa nasopharyngeal carcinoma after radiotherapy. Methods: A total of 114 patients with stage Ⅲ ~ Ⅳa nasopharyngeal carcinoma were enrolled in the study. Radiotherapy combined with adjuvant chemotherapy and cisplatin concurrent chemoradiotherapy were used respectively. Radiotherapy was performed using conventional radiotherapy of nasopharyngeal carcinoma and nasopharyngeal carcinoma Amount of 68 ~ 74Gy / 34 ~ 37 times, total neck prevention dose of 52Gy / 26 times, positive cervical lymph node tumors 64 ~ 68Gy / 32 ~ 34 times, adjuvant chemotherapy for PF regimen 2 to 4 courses of chemotherapy for the same period of cisplatin (Cisplatin) 30mg / time / week × 7 program. Results: All the 114 patients completed the full course of radiotherapy according to the schedule, with 2 ~ 4 courses of PF adjuvant chemotherapy or 30 mg / time / week of cisplatin chemotherapy. Results: The complete remission rate was 100% in all patients, with a median follow-up of 2 years. Four patients in the adjuvant chemotherapy group had local recurrence and 12 patients had distant metastasis. In the same period, none of the patients in radiotherapy and chemotherapy group had local recurrence and 9 patients Distant metastasis, compared with the two groups, the same period of radiotherapy and chemotherapy group of patients with a higher cure rate, the difference was statistically significant. Conclusion: The patients with stage Ⅲ ~ Ⅳa nasopharyngeal carcinoma underwent concurrent chemoradiotherapy with radiotherapy and adjuvant chemotherapy have a higher cure rate.