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目的:探讨诱导化疗在老年局部晚期鼻咽癌中的疗效及毒副作用。方法:选取接受2个周期PF诱导化疗联合放疗的老年局部晚期鼻咽癌患者61例作为研究对象,以性别、年龄、病理类型、治疗开始时间、T与N分期、鼻咽部放疗剂量、颈部放疗剂量、放疗时间作为配对条件,与接受单纯放疗的老年患者1∶1配对,进行生存情况和毒副作用分析,比较组间差异。结果:联合放化组和单纯放疗组5年总生存率分别为65.0%和40.0%,P=0.012。肿瘤相关生存率分别为71.0%和43.0%,P=0.010。无瘤生存率分别为67.0%和48.0%,P=0.027。无复发生存率分别为88.0%和70.0%,P=0.019。无远处转移生存率分别为75.0%和68.0%,P=0.279。联合放化疗组血液毒性大于单纯放疗组(P<0.05),两组Ⅲ级毒性发生率分别为52.5%和31.1%,P=0.017。结论:诱导化疗联合放疗能提高局部晚期老年鼻咽癌患者总生存率、肿瘤相关生存率、无瘤生存率及无复发生存率,未能降低无远处转移生存率;Ⅲ级黏膜炎发生率明显偏高。
Objective: To investigate the efficacy and side effects of induction chemotherapy in elderly locally advanced nasopharyngeal carcinoma. Methods: Sixty-one elderly patients with locally advanced nasopharyngeal carcinoma who underwent two-cycle PF induction chemotherapy combined with radiotherapy were enrolled in this study. Their gender, age, pathological type, treatment start time, T and N staging, nasopharyngeal radiation dose, Department of radiotherapy dose, radiotherapy time as a matching condition, and elderly patients receiving radiotherapy alone 1: 1 paired, the survival and side effects were analyzed to compare the differences between groups. Results: The 5-year overall survival was 65.0% and 40.0% in the combination radiotherapy group and the radiotherapy alone group, respectively, P = 0.012. Tumor-related survival rates were 71.0% and 43.0%, respectively, P = 0.010. The tumor-free survival rates were 67.0% and 48.0%, respectively, P = 0.027. The recurrence-free survival rates were 88.0% and 70.0%, respectively, P = 0.019. No distant metastasis survival rates were 75.0% and 68.0%, respectively, P = 0.279. The combined chemoradiation group had greater hematotoxicity than the radiotherapy group (P <0.05). The grade Ⅲ toxicity of the two groups was 52.5% and 31.1%, respectively, P = 0.017. Conclusion: Induction chemotherapy combined with radiotherapy can improve the overall survival rate, tumor-related survival rate, tumor-free survival rate and recurrence-free survival rate in locally advanced elderly NPC patients, failing to reduce the survival rate without distant metastasis. The incidence of grade Ⅲ mucositis Obviously high.