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目的 对晚期鼻咽癌综合治疗分析。方法 本文回故性分析1986年5月～1991年5月经病理证实晚期鼻咽癌108例首次采用放化综合治疗,其中男性86例,女性22例。按长沙会议分期Ⅲ期56例,Ⅳ期52例,并根据有无配合化疗分为二组,综合组包括放疗前或放疗后及放疗前后等方式配合化疗,无配合化疗为单放组。放疗方法:放疗二组均为~(60)Coγ线外照射,按鼻咽癌常规布野放疗,总剂量65～75Gy/35～38F/50～70d,颈部先切线后垂直,颈部剂量50～55Gy。化疗采用CPM及COF/M 方案,放疗前化疗在放疗前2周先用冲击化疗1～2周期,放疗后化疗在放疗结束后3～4周进行化疗3～4周期,放疗前后化疗其药物及方法同上。结果 二组颈淋巴结肿瘤消退及局部复发无差异,远处转移中位时间综合组14个月,单放组7个月,平均生存期综合组29个月,单放组8个月,三、五年生存率综合组27.4％及8.6％,单放组4％及0,结果 表明晚期鼻咽癌放化综合治疗在克服远处转移及延长寿命方面有一定作用。其中综合组中放疗前放疗及放疗后化疗和放疗前后化疗平均自生存期分别为2年半、3年及9.4个月。结论 对鼻咽癌综合治疗应当选择适当方法,尽量避免放疗前后反复用药。
Objective To analyze the comprehensive treatment of advanced nasopharyngeal carcinoma. Methods In this paper, retrospective analysis from May 1986 to May 1991 by pathology confirmed 108 cases of advanced nasopharyngeal carcinoma for the first time with radiotherapy and chemotherapy, including 86 males and 22 females. According to the Changsha meeting, stage Ⅲ 56 cases, stage Ⅳ 54 cases, and according to the presence or absence of chemotherapy combined with two groups, the comprehensive group, including before radiotherapy or after radiotherapy and before and after radiotherapy and other ways with chemotherapy, without chemotherapy combined with radiotherapy alone group. Radiotherapy methods: The radiotherapy group were all ~ (60) Co γ-ray external radiation, according to the routine field radiotherapy of nasopharyngeal carcinoma, the total dose of 65 ~ 75Gy / 35 ~ 38F / 50 ~ 70d, neck tangent before vertical, neck dose 50 ~ 55Gy. Chemotherapy with CPM and COF / M program, chemotherapy before radiotherapy 2 weeks before the first shock with chemotherapy for 1 to 2 cycles of chemotherapy after radiotherapy 3 to 4 weeks after the end of radiotherapy chemotherapy for 3 to 4 cycles of chemotherapy before and after radiotherapy and its drug Method above. Results There was no difference in subsidence and local recurrence of cervical lymph node in the two groups. The median time to distant metastasis was 14 months in the combined group and 7 months in the single group. The mean survival time was 29 months in the combined group and 8 months in the single group. The five-year survival rate was 27.4% in the comprehensive group and 8.6% in the combined group and 4% and 0% in the single group, respectively. The results showed that the comprehensive radiotherapy and radiotherapy for advanced NPC had a certain effect in overcoming distant metastasis and prolonging the life span. Among them, the average self-survival of chemoradiation before and after radiotherapy and before and after radiotherapy in the combination group was 2 years and a half, 3 years and 9.4 months respectively. Conclusion The comprehensive treatment of nasopharyngeal carcinoma should choose the appropriate method, try to avoid repeated treatment before and after radiotherapy.