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目的 :研究临床Ⅲ期及Ⅳa期初治鼻咽癌患者调强放疗联合化疗的临床疗效及急慢性不良反应。方法 :对40例Ⅲ期、IVa期初治鼻咽癌患者行调强放疗,配合以铂类为基础的全身化疗。结果 :早期不良反应多为1、2级放射性口腔黏膜炎(85%)和1、2级皮肤放射反应(87.5%),患者可耐受。晚期不良反应为口干为主,随着治疗后时间的延长,口干症状逐渐减轻。中位随访时间为40个月,1、3总生存率为95%,85.9%。1、3年局部区域控制率97.4%,91.6%。1、3无远处转移生存率97.4%,81.5%。结论 :调强放疗联合铂类化疗使得Ⅲ期及Ⅳa期鼻咽癌患者的局部区域控制率和总生存率得到了提高,局部区域控制率提高最为显著,不良反应可以耐受,生活质量得到明显的改善。
Objective: To study the clinical efficacy and the acute and chronic adverse reactions of combined ralotherapy and radiotherapy combined with chemotherapy for patients with stage Ⅲa and Ⅳa nasopharyngeal carcinoma. Methods: Forty patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma underwent intensity modulated radiotherapy, combined with platinum-based systemic chemotherapy. Results: Most of the early adverse reactions were grade 1 and 2 radioactive mucositis (85%) and grade 1 and 2 (87.5%). The patients were tolerant. Late adverse reactions mainly dry mouth, with the extension of time after treatment, dry mouth symptoms gradually reduced. The median follow-up time was 40 months, 1,3 overall survival rate was 95%, 85.9%. In 1 year and 3 years, the control rate of the local area was 97.4% and 91.6% respectively. 1,3 without distant metastasis survival rate of 97.4%, 81.5%. Conclusion: IMRT combined with platinum-based chemotherapy improved the local control rate and overall survival rate of patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma, the most significant increase was in regional control rate, the adverse reaction was tolerable, and the quality of life was significantly improved Improvement.