调强放疗同期联合每周奈达铂治疗局部晚期鼻咽癌的临床研究

摘要

Objective:To investigate the major adverse reaction and effects of intensity-modulated radiotherapy with weeky nedaplatin in patients with locally advanced nasopharyngeal carcinoma( NPC). Methods:All 38 patients with NPC were analyzed. 30mg/m2 was administered weekly for 7 cycles from the fist week of intensity-modulated radiotherapy. The prescription dose to the gross target volume( GTV)of nasopharyngeal tumor was 70Gy,for those with positive neck lymph nodes(GTVnd)was 70Gy,clinical target volume 1(CTV1)was 66Gy,and CTV2 was 54Gy. Results:All patients compeleted the planned intensity-modulated radiotherapy and chemotherapy,were eligi-ble for respose and toxicty analysis . The median follow - up time was 3 8 months . The 1 ,2 ,3 - year survival rates were 94. 7%,84. 2%,78. 9%,the local control rates were 100%,94. 7 %,92. 1%,and the distant metastasis-free survival rates were 97. 3%,94. 7%,73. 6%,respectively. Conclusion:Intensity-modulated radiotherapy con-currently with weeky nedaplatin is well tolerable. It may be able to locoregional control rate and overall survival for lo-cally advanced nasopharyngeal carcinoma.%目的：观察调强放疗同期联合每周奈达铂治疗局部晚期鼻咽癌的疗效以及不良反应。方法：38例局部晚期鼻咽癌患者进入分析。所有患者均接受调强放疗。鼻咽肿瘤体积（ GTV）处方剂70Gy，颈部转移淋巴结（GTVnd）70Gy，临床靶体积1（CTV1）66Gy，临床靶体积2（CTV2）54Gy。于放疗第1周起静脉滴注奈达铂30mg/m2，每周1次，连用7周。结果：38例患者均可评价毒副反应及客观疗效。所有患者均完成了同期放化疗，少见严重不良反应。中位随访38个月，全组1、2、3年总生存率分别为94.7％、84.2％、78.9％，1、2、3年局部/区域控制率分别为100％、94.7％、92.1％，1、2、3年无远处转移生存率分别为97.3％、94.7％、73.6％。结论：调强放疗同期联合每周奈达铂治疗局部晚期鼻咽癌病人可达到较高的局部控制率和生存率，不良反应可耐受。