论文部分内容阅读
目的研究鼻咽癌同期调强放化疗的不良反应和最优化方案。方法2005年2月至2008年3月,55例Ⅱ～Ⅳa期的鼻咽癌患者分成单纯放疗组、同期放化疗加辅助化疗组和同期增敏放化疗加辅助化疗组进行前瞻性研究。体检和影像检查评价近期疗效。CTC3.0评价急性不良反应。结果全部患者随访期6～42个月,中位随访期19个月,随访率100%。局部控制率98.2%。1例15月后局部复发;1例11月后肝转移。患者出现的口干、胃肠道反应、皮肤反应、骨髓抑制和体质量下降均不影响治疗完成。急性口腔黏膜反应使化疗不能按计划进行。放疗结束时22例完全缓解,其中单纯放疗、同期放化疗和同期增敏放化疗分别有8例、8例和6例;33例部分缓解,单纯放疗、同期放化疗和同期增敏放化疗各有11例、21例和1例。结论急性口腔黏膜反应是限制同期调强放化疗完成的主要因素。不含5-Fu方案更能被接受,有可能取得更好效果。
Objective To study the adverse reactions and optimization of concurrent radiochemotherapy for nasopharyngeal carcinoma (NPC). Methods From February 2005 to March 2008, 55 patients with stage Ⅱ ~ Ⅳa nasopharyngeal carcinoma were divided into radiotherapy group, concurrent chemoradiotherapy plus adjuvant chemotherapy group and concurrent chemoradiotherapy plus adjuvant chemotherapy group for prospective study. Physical examination and imaging evaluation of the recent treatment. CTC 3.0 Evaluation of Acute Adverse Reactions. Results All patients were followed up for 6 to 42 months. The median follow-up period was 19 months and the follow-up rate was 100%. The local control rate of 98.2%. One case had local recurrence after 15 months and one case had liver metastasis after 11 months. Patients with dry mouth, gastrointestinal reactions, skin reactions, bone marrow suppression and weight loss did not affect the completion of treatment. Acute oral mucosal reactions make chemotherapy can not proceed as planned. Twenty-two patients were completely relieved by the end of radiotherapy, including radiotherapy alone, radiotherapy and chemotherapy in the same period and radiotherapy and chemotherapy in the same period. There were 8 cases, 8 cases and 6 cases respectively. 33 cases of partial remission, radiotherapy alone, concurrent chemoradiotherapy and simultaneous radiotherapy and chemotherapy There were 11 cases, 21 cases and 1 case. Conclusions Acute oral mucosal reaction is the main factor that limits the completion of concurrent chemo-radiotherapy and chemotherapy. Without the 5-Fu program more acceptable, it is possible to achieve better results.