摘要
目的观察调强放射治疗联合替吉奥治疗中晚期鼻咽癌的临床疗效及不良反应。方法选取2011年1月至2015年8月新乡市中心医院收治的66例经病理组织学诊断为鼻咽部鳞状细胞癌Ⅲ~Ⅳa期患者,将患者随机分为单放组(32例)和同步组(34例)。单放组患者采用调强放射治疗,剂量为70~76 Gy;同步组患者在调强放射治疗基础上同步给予替吉奥胶囊60 mg·m^(-2),口服,每日2次,连服28 d,42 d为1个周期,放射治疗结束后继续化学治疗1个周期。2组患者在治疗后3个月、1 a行鼻咽部及颈部磁共振、纤维鼻咽镜、胸部CT、腹部彩色超声检查,观察患者的治疗效果及不良反应。结果治疗后3个月,2组患者治疗均有效,无疾病进展患者,其中单放组患者完全缓解(CR)率为59.38%(19/32),同步组患者CR率为88.24%(30/34),同步组患者CR率显著高于单放组(χ~2=7.180,P<0.05)。治疗后1 a,单放组患者无病生存率59.38%(19/32),低于同步组的73.53%(25/34)(χ~2=5.552,P<0.05);单放组患者总生存率为87.50%(28/32),与同步组的91.18%(31/34)比较差异无统计学意义(χ~2=0.036,P>0.05)。同步组患者口腔黏膜反应(χ~2=4.484,P<0.05)、骨髓抑制(χ~2=5.945,P<0.05)、胃肠道反应(χ~2=4.890,P<0.05)发生率均显著高于单放组;2组患者皮肤反应发生率比较差异无统计学意义(χ~2=0.194,P>0.05)。结论调强放射治疗联合替吉奥治疗局部中晚期鼻咽癌疗效确切,不良反应可耐受。
Objective To observe the clinical effect and adverse reaction of intensity-modulated radiotherapy （IMRT） combined with tegafur,gimeracil and oteracil potassium capsule for treatment of elderly patients with advanced nasopharyngeal carcinoma.Methods Sixty-six patients who were diagnosed as nasopharyngeal carcinoma（squamous cell carcinoma,stage Ⅲ or Ⅳa） by histopathology in Xinxiang Central Hospital from January 2011 to August 2015 were selected and divided into IMRT group （n =32） and radiochemotherapy group （n =34）.The patients in the IMRT group were given IMRT （70-76 Gy）;based on this,the patients in radiochemotherapy group were given tegafur,gimeracil and oteracil potassium capsule（60 mg · m-2,two times per day） orally for 28 days,42 days was a cycle;when the radiotherapy finished,the patients continued to be treated with chemotherapy for one cycle.The treatment effect and the incidence of adverse reactions of patients in the two groups were observed by nasopharyngeal and neck nuclear magnetic resonance,fiber nasopharyngeal mirror,chest computed tomography and abdominal ultrasonography at three months and one year after the treatment.Results At three months after treatment,all patients were effective,no patient was stable disease or progression of disease.The complete remission （CR） rate of patients in the IMRT group and radiochemotherapy group was 59.38% （19/32）,88.24% （30/34） respectively;the CR rate of patients in the radiochemotherapy group was significantly higher than that in the IMRT group（x2 =7.180,P 〈 0.05）.At one year after treatment,the disease-free survival rate of patients in the radiochemotherapy group[73.53% （25/34）] was significantly higher than that in the IMRT group[59.38% （19/32）] （x2 =5.552,P 〈 0.05）.The overall survival rate of patients in the IMRT group and radiochemotherapy group was 87.50 % （28/32）,91.18% （31/34） respectively;there was no statistic difference in the overall survival rate between the two groups（x2 =0.036,P 〉 0.05）.The incidence of oral mucous reaction,myelosuppression and gastrointestinal reaction of patients in the radiochemotherapy group were significantly higher than those in IMRT group （x2 =4.484,5.945,4.890;P 〈0.05）.There was no significant difference in the incidence of skin reaction between the two groups （x2 =0.194,P 〉 0.05）.Conclusion IMRT combined with tegafur,gimeracil and oteracil potassium capsule chemotherapy for advanced nasopharyngeal carcinoma is effective and the toxicity can be tolerated.
出处
《新乡医学院学报》
CAS
2017年第6期532-534,共3页
Journal of Xinxiang Medical University
关键词
替吉奥胶囊
鼻咽癌
调强放射治疗
化学治疗
gegafur,gimeracil and oteracil porassium capsule
nasopharyngeal carcinoma
intensity-modulated radiotherapy
chemotherapy
