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目的:探讨局部晚期鼻咽癌的综合治疗方法。方法:1995年1月至1999年12月,局部晚期鼻咽癌86例。先用面颈联合野放疗36~42 Gy,之后面颈分野,鼻咽继续放疗至66~76 Gy。对鼻咽残存者50例补充近距离治疗,总量12~18 Gy;8例T4患者用立体定向放射外科(伽玛刀)补充剂量7~9 Gy。放疗结束后2周行化疗,药物为顺铂或卡铂、5-氟脲嘧啶、甲酰四氢叶酸钙,1~3个疗程。未分化癌者放化疗同时进行。结果:随访从化疗第1个疗程结束开始至2005年3月。总缓解率(CR+PR)86.1%(74/86)。3、5年局部控制率62.8%(54/86)和39.5%(34/86);3、5年生存率67.4%(58/86)和43.0%(37/86)。随访期未见严重并发症。结果:对局部晚期鼻咽癌用以放疗为主的综合治疗,疗效满意,不会增加严重并发症的发生率。
Objective: To investigate the comprehensive treatment of locally advanced nasopharyngeal carcinoma. Methods: January 1995 to December 1999, 86 cases of locally advanced nasopharyngeal carcinoma. First use of facial and neck joint field radiotherapy 36 ~ 42 Gy, followed by neck and neck, nasopharyngeal radiotherapy continue to 66 ~ 76 Gy. Fifty patients with nasopharyngeal remnant were treated with brachytherapy, totaling 12-18 Gy. Eight patients with T4 were treated with stereotactic radiosurgery (Gamma Knife) at a dose of 7-9 Gy. 2 weeks after the end of radiotherapy chemotherapy, drugs for cisplatin or carboplatin, 5-fluorouracil, leucovorin, 1 to 3 courses. Undifferentiated cancer radiotherapy and chemotherapy at the same time. Results: Follow-up from the end of the first course of chemotherapy to March 2005. The overall response rate (CR + PR) 86.1% (74/86). The three-year and five-year local control rates were 62.8% (54/86) and 39.5% (34/86) respectively. The 3-and 5-year survival rates were 67.4% (58/86) and 43.0% (37/86) respectively. No serious complications were observed during follow-up. Results: The treatment of locally advanced nasopharyngeal carcinoma with radiotherapy-based comprehensive treatment, with satisfactory results, will not increase the incidence of serious complications.