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观察顺铂、阿霉素同期化放疗治疗局部晚期鼻咽癌的疗效及毒副反应 ,探讨该方案的临床可行性。方法 :32例T3~4N2~3M0 局部晚期鼻咽癌患者进入综合治疗组 ,分别在放疗第1、22、43d接受顺铂70mg/m2 +阿霉素30mg/m2 同期化疗 ,化疗当天及第二天水化利尿。另配对选取32例单纯放疗者为对照组。结果 :所有病例如期完成治疗。放疗40Gy 时 ,综合组颈淋巴结有效率较高 (P<0 05) ;放疗结束5~6周后 ,综合组颈淋巴结完全缓解率较单纯放疗组明显提高(P<0 05) ;鼻咽肿瘤缓解率也有所提高 ,但无统计学意义 (P>0 05)。毒性反应主要表现综合组比单纯放疗组更多发生Ⅰ、Ⅱ级骨髓抑制、胃肠道反应和脱发 ;两组所发生的皮肤及粘膜反应相当。结论 :顺铂 +阿霉素同期化放疗 ,可明显提高晚期鼻咽癌患者颈淋巴结转移灶局控率 ,对鼻咽原发灶的控制也有一定帮助 ;对其毒性反应患者可耐受 ,未影响放疗的顺利完成 ,是鼻咽癌综合治疗的可行方法 ,值得进一步观察研究
To observe the efficacy and side effects of cisplatin and doxorubicin concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma and to explore the clinical feasibility of this regimen. Methods: Thirty-two patients with T3 ~ 4N2 ~ 3M0 local advanced nasopharyngeal carcinoma (NPC) were enrolled into the comprehensive treatment group. The patients received cisplatin 70mg / m2 + doxorubicin 30mg / m2 concurrent chemotherapy on the 1st, Tianshui diuretic. Another matched pair selected 32 cases of radiotherapy alone as the control group. Results: All cases completed treatment on schedule. Radiotherapy 40Gy, the comprehensive group of cervical lymph nodes higher efficiency (P <0 05); 5 to 6 weeks after the end of radiotherapy, comprehensive group of cervical lymph node complete remission rate was significantly higher than the radiotherapy group (P <0 05); nasopharyngeal neoplasm The remission rate also increased, but not statistically significant (P> 0.05). Toxicity mainly in the composite group than in the radiotherapy group occurred more grade Ⅰ, Ⅱ myelosuppression, gastrointestinal reactions and hair loss; skin and mucosal reactions occurred in both groups were comparable. Conclusions: The combination of cisplatin + doxorubicin with concurrent radiotherapy can significantly improve the control rate of cervical lymph node metastasis in patients with advanced nasopharyngeal carcinoma, and it is also helpful to control the primary tumor of nasopharynx. It is tolerant to patients with toxic reaction, Affect the successful completion of radiotherapy, nasopharyngeal carcinoma is a feasible method of comprehensive treatment, it is worth further observation