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目的 研究介入插管化疗在晚期鼻咽癌综合治疗中的作用。方法 对３０ 例晚期鼻咽癌患者采用Ｓｅｌｄｉｎｇｅｒ 法选择性咽升动脉或上颌动脉插管化疗，灌注化疗药物，其中顺铂（ＤＤＰ）１００ ｍｇ，氟脲嘧啶（５Ｆｕ）１ ０００ ｍｇ，平阳霉素（ＢＬＭ）１６ ｍｇ。若病变超过鼻咽中线，则行双侧插管，病变主侧注入药量为２／３，其余１／３ 注入对侧。介入治疗后１ 周开始常规放疗，原发灶总量为６０ ～７０ Ｇｙ／８ 周，颈部病灶则为５０ ～６０ Ｇｙ／８ 周。以同期单纯放疗的５０ 例晚期鼻咽癌患者作为对照组。两组放疗方法、时间、剂量分割均相同。结果 介入插管后１６ 例鼻咽肿物缩小，１２ 例颈部淋巴结缩小或松解。患者自觉症状明显好转。鼻咽部原发灶和颈部淋巴结消失所需放射剂量低于对照组（ Ｐ＜ ０ ．０５） 。放疗结束４ 周评定疗效，治疗组与对照组完全缓解率分别为８３３％ 和７２０％ ，两组比较，差异有显著性（ Ｐ＜０ ．０５） 。结论 介入插管化疗加放疗综合治疗晚期鼻咽癌疗效显著，毒副反应轻，为晚期鼻咽癌患者提供了一种新的、安全有效的治疗方法。
Objective To investigate the role of interventional chemotherapy in the comprehensive treatment of advanced nasopharyngeal carcinoma. Methods Seventy patients with advanced nasopharyngeal carcinoma were treated with Seldinger’s selective pharyngeal or maxillary artery catheterization and chemotherapy. The chemotherapy drugs were cisplatin (100 mg), fluorouracil (5Fu) 1 000 mg, Toxin (BLM) 16 mg. If the lesion beyond the nasopharyngeal midline, the line of bilateral intubation, the main lesion into the dose of 2/3, the remaining 1/3 into the contralateral. One week after interventional treatment, conventional radiotherapy was started, with a total primary volume of 60-70 Gy / 8 weeks and a neck area of 50-60 Gy / 8 weeks. 50 cases of advanced nasopharyngeal carcinoma with radiotherapy alone in the same period served as the control group. Two groups of radiotherapy methods, time, dose segmentation are the same. Results After interventional intubation, 16 cases of nasopharyngeal tumor narrowed, and 12 cases of cervical lymph node shrinkage or release. Patients with symptoms improved significantly. Nasopharyngeal primary tumor and cervical lymph node required dose was lower than the control group (P <0 .05). The curative effect was evaluated 4 weeks after the end of radiotherapy. The complete remission rate was 833% in the treatment group and 720% in the control group. There was significant difference between the two groups (P <0.05). Conclusion The interventional chemotherapy combined with radiotherapy in the treatment of advanced nasopharyngeal carcinoma has obvious curative effect and light toxicity, which provides a new, safe and effective treatment for patients with advanced nasopharyngeal carcinoma.