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目的:比较超分割加同期化疗与单纯超分割放疗治疗Ⅲ/Ⅳ期鼻咽癌的生存率,并分析其预后因素。方法:144例鼻咽低分化癌患者随机分入超分割加同期化疗组(放化疗组)与单纯超分割放射治疗(单放组)。两组放射治疗方式相同,1.2Gy/次,2次/d。研究组在放射治疗前、中加用化疗,放疗与化疗同期进行。结果:5年生存率放化疗组和单放组分别为63.3%及50.7%。影响患者预后的因素为N分期、化疗及放射治疗中血红蛋白量的水平。单放组血红蛋白正常患者可获得血红蛋白异常组加用化疗的相近效果。结论:超分割放射加同期化疗治疗Ⅲ/Ⅳ期鼻咽癌能提高生存率。化疗对N2、N3的患者影响更大。多因素回归法分析N分期、是否加用化疗和放射治疗中血红蛋白量是否正常是影响预后的独立因素。
OBJECTIVE: To compare the survival rates of stage Ⅲ / Ⅳ nasopharyngeal carcinoma with superfractionated plus synchronous chemotherapy and simple hyperfractionated radiotherapy and to analyze its prognostic factors. Methods: One hundred and forty-four patients with nasopharyngeal poorly differentiated carcinoma were randomly divided into superfractionated plus concurrent chemotherapy group (radiochemotherapy group) and pure hyperfractionated radiotherapy group (single radiotherapy group). Radiation therapy in both groups was the same, 1.2Gy / time, 2 times / d. Study group before radiotherapy, plus chemotherapy, radiotherapy and chemotherapy over the same period. Results: The 5-year survival rate was 63.3% and 50.7% in radiotherapy and chemotherapy group and radiotherapy alone group respectively. Factors affecting the prognosis of patients for the N staging, chemotherapy and radiotherapy hemoglobin levels. Single hemoglobin group patients with normal hemoglobin can be obtained with chemotherapy similar effects. Conclusion: Surgical treatment of stage Ⅲ / Ⅳ nasopharyngeal carcinoma with hyperfraction radiotherapy and concurrent chemotherapy can improve the survival rate. Chemotherapy on N2, N3 patients greater impact. Multivariate regression analysis of N staging, whether to add chemotherapy and radiotherapy in the amount of hemoglobin is an independent prognostic factor.