调强放疗同期化疗治疗局部中晚期鼻咽癌

摘要

Objective:To evaluate the clinical efficacy of intensity - modulated radiotherapy combined with con-current chemotherapy for locally advanced nasopharyngeal carcinoma. Methods:All 107 cases of nasopharyngeal car-cinoma patients,were randomly divided into observation group and control group,55 cases in the observation group,52 cases in the control group. Patients of two groups were taken the same chemotherapy,the patients in observation group were combined with intensity modulated radiation therapy,the control group take the conventional radiation therapy. Results:The total effective rate of observation group was 94. 54%(52 / 55),the control group total effective rate was 75. 00%(39 / 52),P < 0. 05. Acute toxicity reaction rate of observation group was 41. 82%(23 / 55),the control group was 71. 15%(37 / 52),P < 0. 05. Observe grpup long term adverse reaction incidence rate was 20. 00%(11 / 55),in the control group was 38. 46%(20 / 52),P < 0. 05. Observation group 3 - year survival rate was 76. 36% ,control group was 71. 54%(P > 0. 05). Observation group 5 - year survival rate was 65. 45% ,control group was 40. 38%(P< 0. 05). Observation group 5 - year cumulative recurrence rate was 10 . 91 % ,control group was 26 . 92 %(P< 0. 05). Observation group 5 - year no distant metastasis survival rate was 85. 45% ,in control group was 67. 31%(P < 0. 05). Conclusion:Intensity - modulated radiotherapy and concomitant chemotherapy can significantly improve the clinical efficacy,reduce the incidence of adverse reactions in patients with locally advanced nasopharyngeal carci-noma.%目的：探讨调强放疗联合同期化疗治疗局部晚期鼻咽癌的疗效。方法：选择2009年1月至2010年12月我院收治的107例鼻咽癌患者，按照随机数字表法将其分为观察组和对照组，其中观察组55例、对照组52例。两组患者均采取相同的化疗方案，观察组患者联合调强放疗，对照组则采取常规放疗，比较两组患者临床疗效及不良反应。结果：观察组治疗总有效率为94.54%（52/55），对照组治疗总有效率为75.00%（39/52），P <0.05。观察组急性毒性反应发生率为41.82%（23/55），对照组急性毒性反应发生率为71.15%（37/52），P <0.05。观察组患者远期不良反应发生率为20.00%（11/55），对照组患者远期不良反应发生率为38.46%（20/52），P <0.05。观察组患者3年生存率为76.36%，对照组患者3年生存率为71.54%（P >0.05）。观察组患者5年生存率为65.45%，对照组患者5年生存率为40.38%（P <0.05）。观察组患者5年累积复发率为10.91%，对照组患者5年累积复发率为26.92%（P <0.05）。观察组患者5年无远处转移生存率为85.45%，对照组患者5年无远处转移生存率为67.31%（P <0.05）。结论：调强放疗同期化疗治疗局部中晚期鼻咽癌能够显著提高患者临床疗效、减少不良反应发生率，值得临床进一步观察研究。