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目的:探讨诱导化疗配合加速分割放疗对Ⅲ期、Ⅳa期鼻咽癌放疗疗效的影响。方法:78例初治鼻咽癌患者随机分组:观察组在放疗前给予PF方案诱导化疗1周期,对照组予加速分割放疗。结果:诱导化疗可以减轻鼻咽癌症状及缩小颈部淋巴结;观察组淋巴结消退时颈部放疗剂量DT(45.37±7.26)Gy明显低于对照组(60.37±8.24)Gy(P<0.01);观察组淋巴结完全缓解率92.31%明显高于对照组71.79%(P<0.05),而两组淋巴结有效率(分别为100%、94.9%)差异无显著性(P>0.05);观察组放疗结束时淋巴结残留率7.69%明显低于对照组24%(P<0.05)。观察组放疗后急性毒副反应如恶心呕吐、口腔黏膜反应及白细胞下降等与对照组相比无明显增加(P>0.05)。结论:诱导化疗可以提高鼻咽癌放疗的近期疗效,而急性毒副反应并无增加。
Objective: To investigate the effect of induction chemotherapy combined with accelerated radiotherapy on the efficacy of radiotherapy for stage Ⅲa and Ⅳa nasopharyngeal carcinoma. Methods: 78 patients with newly diagnosed nasopharyngeal carcinoma were randomly divided into two groups: the observation group received PF regimen for one cycle of chemotherapy before radiotherapy and the control group for accelerated radiotherapy. Results: The induction of chemotherapy could reduce the symptoms of nasopharyngeal carcinoma and reduce the size of cervical lymph nodes. The dose of cervical radiotherapy DT (45.37 ± 7.26) Gy was significantly lower than that of the control group (60.37 ± 8.24) Gy (P <0.01) The complete remission rate of group lymph node was 92.31%, which was significantly higher than that of control group (71.79%, P <0.05), while there was no significant difference between the two groups (100%, 94.9%, respectively) The residual rate of lymph nodes 7.69% was significantly lower than that of the control group 24% (P <0.05). There was no significant increase (P> 0.05) in the observation group of acute side effects such as nausea and vomiting, oral mucosal response and leukopenia after radiotherapy. Conclusion: Induction chemotherapy can improve the short-term effect of radiotherapy for nasopharyngeal carcinoma, but there is no increase of acute toxicity.