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目的观察放射治疗同时化疗对中晚期鼻咽癌的毒副作用及疗效。方法Ⅲ期和Ⅳa期初治鼻咽癌患者分为二组,化放组33例于放疗中第1,4周给予化疗(DDP40mg第1天￣第3天,5-Fu750mg第1天￣第5天),单放组29例,鼻咽部原发灶放射治疗DT68￣72Gy,7￣7.5周,颈部DT50￣76Gy,5￣8周。结果急性黏膜反应3级化放疗组(23/33),明显多于单放疗组(8/29);血液学毒性二组无差异;放疗结束鼻咽部病灶完全退缩化放疗组(单放组)为21/33例(11/29)例;颈部淋巴结完全消退化放疗组(单放组)为18/29例(10/23)例,放疗结束3个月后鼻咽部病灶完全退缩化放疗组(单放组)为28/33例(16/29)例,颈部淋巴结完全消退化放疗组(单放组)为25/29例(13/23)例。结论同步化放疗可以提高近期鼻咽病灶和颈部淋巴结的完全消退率,对于其毒副反应如急性黏膜反应和血液毒性反应等可耐受,而远期疗效仍需进一步随访研究。
Objective To observe the toxicity and side effects of concurrent radiotherapy and chemotherapy on advanced nasopharyngeal carcinoma. Methods Ⅲ and Ⅳa early nasopharyngeal carcinoma patients were divided into two groups, 33 cases of chemoradiotherapy group in the first and fourth week of radiotherapy given chemotherapy (DDP40mg day 1 ~ day 3, 5-Fu750mg day 1 ~ 5 Day), single group of 29 cases, nasopharyngeal primary tumor radiotherapy DT68 ~ 72Gy, 7 ~ 7.5 weeks, neck DT50 ~ 76Gy, 5 to 8 weeks. Results The grade 3 radiotherapy group (23/33) in acute mucosal reaction was significantly more than that in single radiotherapy group (8/29), no difference in hematological toxicity between the two groups, the complete regression of nasopharyngeal lesions after radiotherapy radiotherapy group ) Were 21/33 (11/29) cases. The cervical lymph nodes were completely eliminated in the radiotherapy group (single radiotherapy group), 18/29 (10/23) cases. The nasopharyngeal lesions completely retreated 3 months after the end of radiotherapy There were 28/33 cases (16/29) in the chemoradiotherapy group and 25/29 cases (13/23 cases) in the radical radiotherapy group (complete radiotherapy group). Conclusions Simultaneous radiotherapy can improve the complete regression rate of nasopharyngeal lesions and cervical lymph nodes in the near future, and can tolerate its side effects such as acute mucosal reaction and hematologic toxicity. However, long-term follow-up study is still needed.