ABSTRACT
Objective To investigate the effects and toxic side effects of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy in nasopharyngeal carcinoma.Methods 141 patients of nasopharyngeal carcinoma divided into two groups randomly.All patients treated two-dimension exact radiotherapy and concurrent chemotherapy which combined DDP and 5-Fu intravenously for two circles,then experiment group started adjuvant chemotherapy 3 weeks later after above treatment,which intravenous DDP and 5-Fu for other three circles.Results All patients completed concurrent radiotherapy and chemotherapy,63 patients of treatment group completed adjuvant chemotherapy.The mainly toxic side effect was mucositis,leukopenia and low-platelet,and gastrointestinal reaction during therapy,there is no statistical significance in two groups.The regression rate of lymph nodes is 94.4 ％(n=67)and 87.3 ％(n=62)in nasopharynx and neck after 3 month of radiotherapy and concurrent chemotherapy.All patients followed up 3 years.The total survival rate of two groups were 94.3 ％,84.8 ％,78.6 ％ and 90.1％,75.0 ％,62.5 ％ respectly in 1,2 and 3 year,the mean survival period was 36 months and 27 months,and this differece was statistical significance(x2=7.356,P=0.007).The total survival rate of Ⅲ stage patients of two groups were 98.2 ％,92.5 ％,83.7 ％ and 93.0 ％,83.2 ％,68.2 ％ respectly in 1,2 and 3 year,the both mean survival period was 36 months,and this differece was statistical significance(x2=8.081,P=0.005).The total survival rate of Ⅳ stage patients of two groups were 81.3 ％、53.8 ％、42.9 ％ and 78.6 ％、36.4 ％ 、22.3 ％ respectly in 1,2 and 3 year,the meat survival period were 22 month and 14 month respectly,and this differece was statistical significance(x2=3.903,P=0.048).The progression-free survival rate of two groups were 90.0 ％、76.2 ％、68.8 ％,and 81.7 ％、60.3 ％、34.3 ％ respectly in 1,2 and 3 year,the meat progression-free survival period was 30months and 22months,and this differece was statistical significance as well(x2=13.616,P=0.000).Conclusion The therapy of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy was obviously increased total survival rate and progression-free survival rate in nasopharyngeal carcinoma,especially to Ⅲ and Ⅳ stage patient of nasopharyngeal carcinoma.But the long period effects still remains unclear.