诱导化疗联合同期放化疗治疗ⅢⅣa期鼻咽癌的临床研究.doc

诱导化疗联合同期放疗% vs 80.5%，85.7% vs72.6% P0.05）。研究组和对照组的5年生存率和无瘤生存率分别为71.70% vs 61.3% 和 56.6% vs 47.6％，差异有统计学意义（P0.05）。研究组毒性反应增加，以骨髓抑制、胃肠反应和口腔黏膜炎为主。结论 诱导化疗联合同期放化疗可提高局部晚期鼻咽癌的临床疗效和生存率。毒副反应较大，但不影响治疗进程。 关键词: 鼻咽肿瘤;　诱导化疗;同期化放疗;生存分析 Clinical study of Induction Chemotherapy Plus Concurrent Radiochemotherapy in the Treatment of stage Ⅲ and Ⅳa advanced Nasopharyngeal Carcinoma DONG Chao，REN Yan-xin，YANG Run-xiang，Zhuang Li，REN Hong-xuan. 1.Dapartment of the second medical oncology,The Third Affiliated Hospital of Kunming Medical University ,Kunming 650018，China；2. Dapartment of head and neck Abstract：objective To evaluate the efficacy and toxicity of radiotherapy alone and induction chemotherapy plus concurrent chemoradiotherapy for stageⅢand Ⅳa nasopharyngeal cancer(NPC) and to compare the influence on survival rates.Methods To analysis clinical datas of 169 locally advanced NPC patients from 2000 to 2005. 56 cases were treated two cycles of induction chemotherapy followed by conventional radical radiotherapy and concurrent weekly cisplatin chemotherapy (study group)； 113 were treated with radiotherapy alone(control group). The therapeutic response and adverse reaction of the two groups were compared.The 5-year overall and disease-free survival rates were analyzed by Kaplan-Meier.Results the complete response rates of the nasopharyngeal control and the cervical lymph nodes control in study group were superior to that in control group(92.8%vs80.5%，85.7%vs72.6% P0.05). The 5-year overall survival rates in study group and control group were 71.7% and 56.6% respectively.The disease-free survival rates in two groups were 61.3% and 47.6％。The 5-year overall and disease-free survival rates were significantly higher in study group than in control group ( P0.05). The rates of toxicity effect in study group were higher than in control group.the main toxicity was hematological toxicties,gastrointestinal reaction and oral mucositis. Conclusions The induction chemotherapy plus concurrent c