放疗同期紫杉醇化疗治疗局部晚期鼻咽癌临床研究

目的探讨紫杉醇同期放化疗治疗局部晚期鼻咽癌（T4N2～3M0）的临床疗效及不良反应。方法 2005年1月至2006年5月我院收治经病理确诊为低分化鳞癌的鼻咽癌患者,按福州分期T4N2～3M0,共60例,随机分为同期放化疗组（30例）和单纯放疗组（30例）。同期放化组化疗方案：在放疗同时给予紫杉醇60mg,每周1次,共7次;放疗方案同单纯放疗组。结果放疗结束后3个月,同期放化组、单纯放疗组鼻咽肿瘤完全消退率分别为93.3%和86.7%（P〉0.05）,1,2,3年局控率同期放化组、单纯放疗组分别为93.3%、86.7%、66.7%和90.9%、63.3%、43.3%。1,2,3年生存率分别为96.7%、83.3%、76.7%和86.7%、66.7%、53.3%。同期放化组的白细胞下降、消化道反应等毒性副反应明显高于单纯放疗组（P〈0.05）,但不延长放疗总疗程。结论同期放化疗治疗局部晚期鼻咽癌有助于提高生存率,减少局部复发和远处转移。

Clinical study of radiotherapy combined with paclitaxel chemotherapy for locally advanced nasopharyngeal carcinoma

Objective To investigate the efficacy and toxicity of radiotherapy combined with chemotherapy in treatment of patients with locally advanced nasopharyngeal carcinoma.Methods From January 2005 to May 2006,60 patients with pathologically comfirmed nasopharyngeal low differentiated squamous cell carcinoma at T4N2～3M0 stage according to 92 Fuzhou staging system were randomly allocated into concurrent chemotherapy-radiotherapy group（30 patients）and radiotherapy group（30 patients）.The concurrent chemotherapy-radiotherapy group received paclitaxel 60mg once a week for 7 weeks,similar dose and fractionation of radiotherapy was administered in both groups.Results Complete response rate of the concurrent chemotherapy-radiotherapy group and radiotherapy group three months after treatment were 93.3% and 86.7%,respectively（P0.05）.The 1,2,3-year local control rates were 93.3%,86.7%,66.7% and 90.9%,63.3%,43.3%,respectively.The 1,2,3-year survival rates were 96.7%,83.3%,76.7% and 86.7%,66.7%,53.3%,respectively.There were statistically significant differences between the two groups.Leucopenia and gastrointestinal toxicity were more severe in concurrent chemotherapy-radiotherapy group than in radiotherapy group（P0.05）,but did not affect radiotherapy.Conclusion Concurrent chemotherapy-radiotherapy can increase the survival rates and decrease the distant metastasis in patients with locally advanced nasopharyngeal carcinoma.