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目的观察鼻咽癌后程三维适形放疗加时间调节化疗与常规放化疗的疗效和副作用。方法将86例患者用信封法随机分为后程三维适形放疗加时间调节化疗组(CCR组)和常规放化疗组(RCR组)。两组均先进行2个周期顺铂+氟尿嘧啶+亚叶酸钙不同给药方法的诱导化疗,之后加不同方式的放疗。RCR组用药量同CCR组,鼻咽病灶放疗剂量均为70Gy7周。结果完全缓解率、有效率CCR组和RCR组分别为45.5%、95.5%和23.8%、71.4%。两组差异有统计学意义(P<0.05)。两组1、3年生存率差异无统计学意义(P>0.05)。RCR组相对于CCR组口腔炎、恶心呕吐、腹泻更多见(P<0.05),骨髓毒性反应的差异亦有统计学意义(P<0.05)。结论鼻咽癌后程三维适形放疗加时间调节化疗治疗较常规放化疗有较好效果,且副反应较低。
Objective To observe the efficacy and side effects of three-dimensional conformal radiotherapy of late course of nasopharyngeal carcinoma plus time-adjusting chemotherapy and conventional radiotherapy and chemotherapy. Methods Eighty-six patients were randomly divided into three-dimensional conformal radiotherapy plus time-adjusted chemotherapy (CCR) group and conventional radiochemotherapy (RCR group) by envelope method. Two groups were first conducted two cycles of cisplatin + fluorouracil + leucovorin different administration of chemotherapy, followed by different ways of radiotherapy. The dosage of RCR group was the same as that of CCR group, and the dosage of radiotherapy for nasopharyngeal lesions was 70 Gy for 7 weeks. Results The complete remission rate and effective rate were 45.5%, 95.5%, 23.8% and 71.4% in the CCR group and the RCR group, respectively. The difference between the two groups was statistically significant (P <0.05). There was no significant difference in the 1, 3-year survival rates between the two groups (P> 0.05). The incidence of stomatitis, nausea, vomiting and diarrhea in RCR group was higher than that in CCR group (P <0.05), and the differences in bone marrow toxicity were also statistically significant (P <0.05). Conclusions Three-dimensional conformal radiotherapy of late course of nasopharyngeal carcinoma plus time-adjusted chemotherapy has better effect than conventional radiotherapy and chemotherapy, and the side effects are low.