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目的 探讨局部注射顺铂对颈部淋巴结转移癌的放疗增敏作用。方法 80例经病理证实的头颈部及胸部恶性肿瘤伴颈部或锁骨上淋巴结转移、淋巴结最大直径大于 3cm、需进行根治性放射治疗的患者 ,分颈部转移性淋巴结注射顺铂放疗增敏组 (增敏组 ) 5 0例 ,同期单纯放疗组 (对照组 ) 30例 ,2组均用60 CO -γ射线或 6MVX线加 7～ 14MeVβ射线常规放疗 ,每周 5次 ,DT :2Gy/次 ,总量为 5 5～ 75Gy/5～ 8周。增敏组于放疗 2周即DT :2 0Gy后 ,顺铂 2 0～ 40mg(用 10～ 2 0ml生理盐水溶解 )淋巴结内多点注射 ,于每周五放疗后注射 1次 ,直到淋巴结完全消退或放疗结束后仍残留者继续注射 2～ 3次。结果 增敏组近期总有效率为 92 % ,淋巴结全消率为 80 % ;对照组近期总有效率为 73% ,淋巴结全消率为 43% ;2组比较统计学有显著性差异 (P <0 .0 5 )。放疗达PR及CR时的顺铂增敏比分别为 1.32和 1.2 3。结论 局部注射顺铂对颈部淋巴结转移癌的放疗有增敏作用。
Objective To investigate the radiotherapy sensitization effect of local injection of cisplatin on cervical lymph node metastases. Methods 80 cases of pathologically confirmed head and neck and thoracic malignancies with cervical or supraclavicular lymph node metastasis, lymph node maximal diameter greater than 3 cm, patients undergoing radical radiotherapy, and cervical metastatic lymph node injection with cisplatin radiosensitization Group (sensitized group) 50 cases, the same period alone radiotherapy group (control group) 30 cases, both groups were treated with 60 CO-gamma ray or 6MVX line plus 7 ~ 14MeV beta ray routine radiotherapy, 5 times a week, DT: 2Gy / This time, the total amount was 55-75Gy/5-8 weeks. In the sensitization group, 2 weeks after radiotherapy, DT: 20 Gy, 20-40 mg of cisplatin (dissolved with 10-20 ml of saline) was injected into multiple lymph nodes, and injected once a week after radiotherapy until the lymph nodes completely disappeared. Or after the end of radiotherapy, those who still remain will continue to inject 2 or 3 times. Results The total effective rate was 92% in the sensitization group and 80% in the lymph nodes. The total effective rate was 73% in the control group and 43% in the lymph nodes. There was a statistically significant difference between the two groups (P < 0 .0 5 ). The cisplatin sensitization ratios for radiotherapy to PR and CR were 1.32 and 1.2 3, respectively. Conclusion Local injection of cisplatin has a sensitizing effect on radiotherapy of lymph node metastases in cervical lymph nodes.