同步放化疗对晚期鼻咽癌患者生存预后的影响分析

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目的:探讨同步放化疗治疗局部晚期鼻咽癌(LA-NPC)患者的临床效果及对患者预后的影响。方法:选取2009年至2012年收治的87例LA-NPC患者作为研究对象,根据治疗方式分为联合组(46例)和放疗组(41例),联合组采用放疗联合化疗的方法,放疗组仅采用单纯放疗治疗。结果:治疗后,联合组完全缓解率为39.13%,高于放疗组的19.52%(P<0.05);血清CD44及唾液酸水平均低于放疗组(P<0.05);患者中位生存时间为33.5个月,长于放疗组患者的30.7个月(Log-rankχ~2=3.792,P=0.042);Ⅱ+Ⅲ度口腔黏膜炎发生率为30.43%,Ⅱ+Ⅲ度放射性皮炎发生率为26.07%,Ⅱ+Ⅲ度恶心呕吐发生率为30.43%,高于放疗组的12.21%、14.63%、9.76%,差异均具有统计学意义(P<0.05)。结论:同步放化疗治疗LA-NPC患者有利于进一步提高治疗效果、延长患者的生存期,但是不良反应发生率较高。 Objective: To investigate the clinical effect of concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) and its prognosis. Methods: A total of 87 patients with LA-NPC treated in our hospital from 2009 to 2012 were enrolled in this study. The patients were divided into combined group (46 cases) and radiotherapy group (41 cases) according to the treatment mode. Radiotherapy combined with radiotherapy Only radiotherapy alone. Results: After treatment, the complete remission rate was 39.13% in the combination group, which was higher than that in the radiotherapy group (19.52%, P <0.05). The serum CD44 and sialic acid levels were lower than those in the radiotherapy group (P <0.05) 33.5 months, longer than 30.7 months (Log-rankχ2 = 3.792, P = 0.042). The incidence of grade II + III oral mucositis was 30.43%, and the incidence of grade II + III radiation dermatitis was 26.07% , The incidence of grade Ⅱ + Ⅲ nausea and vomiting was 30.43%, which was higher than that of radiotherapy group (12.21%, 14.63%, 9.76%, respectively). The difference was statistically significant (P <0.05). Conclusions: Simultaneous chemoradiotherapy for patients with LA-NPC is beneficial to further improve the therapeutic effect and prolong the survival of patients, but the incidence of adverse reactions is higher.
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