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目的探讨替吉奥胶囊(维康达)联合三维适形放疗同期治疗局部晚期鼻咽癌的近期疗效和不良反应。方法局部晚期鼻咽癌患者32例,采用以下方案治疗:化疗:维康达80 mg/(d.m2),分2次餐后口服,放疗第8天开始,连服28 d为1周期,休息2周至放疗结束。放疗:所有患者均为根治性三维适形放疗(3D-CRT),处方剂量GTV 66～70 Gy,共33～35次,颈部预防照射剂量(DT)50 Gy,1次/d,5 d/周。按RECIST1.1标准评价客观疗效和不良反应。结果入组32例患者,31例均完成根治性放疗,1例因进食少低蛋白血症治疗中自动放弃治疗。可评价疗效的31例。CR 19.3%(6/31)、PR77.4%(24/31)、SD 0.03%(1/31),近期有效率96.7%。治疗过程中毒副反应主要为恶心、呕吐、放射性口腔炎和骨髓抑制,没有患者发生4级及以上的毒副反应,无治疗相关死亡。结论维康达联合三维适形放疗同期治疗局部晚期鼻咽癌的近期疗效可靠,不良反应可以耐受,值得临床进一步研究应用。
Objective To investigate the short-term curative effect and side effects of the treatment of locally advanced nasopharyngeal carcinoma with tigeo capsule (Wei Kang Da) combined with three-dimensional conformal radiotherapy. Methods Thirty-two patients with locally advanced nasopharyngeal carcinoma were treated with the following regimen: Chemotherapy: Vecon 80 mg / (d.m2), orally after 2 meals, beginning on day 8 after radiotherapy, Rest for 2 weeks to end of radiotherapy. Radiotherapy: All patients underwent radical three-dimensional conformal radiotherapy (3D-CRT) at a prescribed dose of GTV 66-70 Gy for 33-35 times, 50 Gy for cervical prevention dose (DT), once / d for 5 days /week. According to RECIST1.1 standard evaluation of objective efficacy and adverse reactions. Results 32 patients were enrolled in the study, 31 patients underwent radical radiotherapy and 1 patient was given up for treatment due to hypoalbuminemia. Evaluation of the efficacy of 31 cases. CR 19.3% (6/31), PR77.4% (24/31), SD 0.03% (1/31), the recent efficiency of 96.7%. Toxic side effects during treatment were mainly nausea, vomiting, radiation stomatitis and myelosuppression. No patient had grade 4 and above toxic side effects and no treatment-related deaths occurred. Conclusion Weikangda combined with three-dimensional conformal radiotherapy for the treatment of locally advanced nasopharyngeal carcinoma over the same period of reliable efficacy, adverse reactions can tolerate, worth further clinical study.