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目的 :评价诱导化疗加放射治疗和单纯放疗治疗Ⅳ (N3 M0 )期鼻咽癌的临床疗效。方法 :将经病理证实的 3 4例Ⅳ (N3 M0 )期鼻咽癌 3 4例随机分为诱导化疗加放疗组 (Ⅰ )和单纯放疗组 (Ⅱ )。Ⅰ组放疗前应用PF方案(DDP+5 -FU)化疗 2周期 ,2组放疗方法相同。结果 :Ⅰ组和Ⅱ组鼻咽部肿瘤完全消退率分别为88.2 %和 82 .4% ,颈部转移淋巴结完全消退率分别为 94.1 %和 88.2 % ,差异无显著性 (P >0 .0 5 ) ;Ⅰ组和Ⅱ组 3年生存率分别为 70 .6%和 47.1 % ,差异有显著性 (P <0 .0 5 ) ;Ⅰ组和Ⅱ组远处转移率分别为 2 3 .5 %和41 .2 % ,差异有显著性 (P <0 0 5 )。Ⅰ组治疗毒副反应比Ⅱ组重。结论 :诱导化疗加放射治疗Ⅳ (N3 M0 )期鼻咽癌 ,可以提高 3年生存率 ,减少远处转移率 ,毒副反应比单纯放疗大 ,但不影响治疗进程。
Objective: To evaluate the clinical effects of induction chemotherapy plus radiotherapy and radiotherapy alone in the treatment of stage Ⅳ (N3 M0) NPC. Methods: 34 cases of stage Ⅳ (N3 M0) nasopharyngeal carcinoma confirmed by pathology were randomly divided into induction chemotherapy plus radiotherapy (Ⅰ) and radiotherapy alone (Ⅱ). Group Ⅰ before radiotherapy PF regimen (DDP +5 -FU) chemotherapy 2 cycles, 2 groups of the same radiotherapy. Results: The complete regression rates of nasopharyngeal tumors in group Ⅰ and group Ⅱ were 88.2% and 82.4% respectively, and the complete regression rates of cervical lymph node metastasis were 94.1% and 88.2% respectively, with no significant difference (P> 0.05). ). The three-year survival rates of group Ⅰ and group Ⅱ were 70.6% and 47.1%, respectively, with significant difference (P0.05). The distant metastasis rates of group Ⅰ and group Ⅱ were 23.5% And 41.2%, the difference was significant (P <0 05). Group Ⅰ treatment toxicity than Ⅱ group. Conclusion: Induction chemotherapy plus radiotherapy of stage Ⅳ (N3 M0) NPC can improve the 3-year survival rate and reduce the distant metastasis rate. The toxic side effects are larger than radiotherapy without affecting the course of treatment.