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目的观察肿节风防治鼻咽癌同期放化疗毒副反应的临床疗效。方法 2006年6月至2008年8月经由病理活检确诊、初治的接受同期放化疗的Ⅲ～IVa期鼻咽癌患者100例,于放疗前3天开始口服肿节风,一次10g,一日3次,持续到放疗结束。放疗采用常规放疗方案,化疗采用PF方案,选择同期接受调强适型放疗联合PF方案同期化疗的100例Ⅲ～IVa期鼻咽癌患者进行对照研究。结果①两组原发灶和颈部淋巴结转移灶有效率100%,试验组原发灶及颈部淋巴结CR为69%,73%,对照组为80%,81%,差异无统计学意义。②两组急性放射反应中,白细胞下降及口干的发生率差异无统计学,而口腔黏膜炎及皮肤反应,对照组发生率及严重程度均低于试验组。③试验组的1年及2年总生存率、无瘤生存率、复发率以及远处转移率分别为:97%、86%;92%、70%;3%、11%;6%、19%;对照组为100%、93%;97%、81%;1%、5%;2%、12%,差异无统计学意义。④两组口干及放射性龋齿的发生率差异无统计学意义;张口困难及颈部软组织纤维化的发生率差异有统计学意义,对照组低于试验组。结论调强放疗在正常器官组织保护方面仍有着绝对的优势,而加用肿节风后的常规放疗组,对唾液分泌减少引起的口干及放射性龋齿有显著的缓解作用,可改善患者的生存质量,对于腮腺的保护接近调强放疗的效果。
Objective To observe the curative effect of treating swollen gonorrhea on the side effects of radiotherapy and chemotherapy of nasopharyngeal carcinoma. Methods From June 2006 to August 2008, 100 patients with stage III-IVa nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy were diagnosed by pathological biopsy. Oral swollen arthritis was started 3 days prior to radiotherapy, once a day for 10 days. 3 times, until the end of radiotherapy. Radiotherapy using conventional radiotherapy program, chemotherapy using PF regimen, select the same period to accept the intensity modulated radiotherapy combined with PF regimen chemotherapy in 100 cases of stage Ⅲ ~ IVa nasopharyngeal carcinoma patients for controlled study. Results ① The effective rate of primary and cervical lymph node metastasis was 100% in both groups. The CR of primary tumor and cervical lymph node in the experimental group was 69% and 73% respectively, while the control group was 80% and 81% respectively. There was no significant difference between the two groups. ② There was no significant difference in the incidence of leukopenia and dry mouth among the two groups of acute radiation reaction, while the incidence and severity of oral mucositis and skin reaction were lower in the control group than in the experimental group. ③ The 1-year and 2-year overall survival rate, tumor-free survival rate, recurrence rate and distant metastasis rate of the experimental group were 97%, 86%, 92%, 70%, 3%, 11%, 6%, 19 %; The control group was 100%, 93%; 97%, 81%; 1%, 5%; 2%, 12%, the difference was not statistically significant. There was no significant difference in incidence of dry mouth and radioactive dental caries in the two groups. There was a significant difference in the incidence of mouth opening and cervical soft tissue fibrosis between the two groups. The control group was lower than the experimental group. Conclusion IMRT still has an absolute advantage in the protection of normal organs and tissues. However, the conventional radiotherapy group treated with swollen-knot wind can significantly improve the survival of patients with dry mouth and radioactive dental caries caused by decreased salivary secretion Quality, protection for the parotid gland close to the effect of IMRT.