局部晚期鼻咽癌舌脉变化与治疗疗效分析 医学论文

1、局部晚期鼻咽癌舌脉变化与治疗疗效分析 医学论文 本文由中国论文范文收集整理。 作者：郭建新 娄鹏荣 陶庆松 徐正阳 陈俊 王锡恩【摘要】 目的 舌脉异常与恶性肿瘤的 治疗 和预后有相关性，放疗配以化疗是治疗局部晚期鼻咽癌可能根治的有效 方法 ，但是仍有较大部分患者出现局部复发以及远处转移，通过 研究 舌脉的变化探讨局部晚期鼻咽癌治疗预后因素。方法将68例进入同步根治性放化疗的局部晚期鼻咽癌分为舌脉正常组A组和舌脉异常组B组，采用常规放疗技术，放疗第一天开始同步PF 方案化疗二周期，放疗后二周开始辅助化疗二周期，隔28天一周期。结果 A组、B组五年生存率分别为51?3、47?7，组间差别无统计学

2、意义；A组、B组五年无远处转移率分别为75?2、60?5，A组显著高于B组（P0?05）。结论舌脉是否异常对局部晚期鼻咽癌病人的五年生存率无显著 影响 ，但可能对无远处转移率有影响。提示舌脉变化可作为鼻咽癌病人是否易发生远处转移的指标之一。 【关键词】 鼻咽癌 舌脉 同步放化疗Abstract: Objective The abnormity of glossal venation was always correlative with the therapy and prognosis of carcinoma. For locally advanced nasopharyngeal car

3、cinoma, radiotherapy combined with chemotherapy is the potent radical method, but loco?regional recurrence and distant metastasis occur in many patients. This study wants to discuss the prognosis of treatment by observing the change of glossal venation. Methods 68 patients with locally nasopharyngea

4、l carcinoma who received concurrent chemoradiotherapy were divided into two arms: normal glossal venation (arm A) and abnormal glossal venation (arm B). All patients were received conventional radiotherapy, and chemotherapy (cisplatin/fluorouracil) was given concurrently, after two weeks of radiothe

5、rapy, patients were received two cycles chemotherapy again. The 5?year overall survival rates and free distant metastases rate were observed.Results The 5?year overall survival rates were 51?3% for arm A and 47?7% for arm B, no significant difference in two arms; the 5?year free distant metastases r

6、ate in arm A was 75?2%, compared with 60?5% in arm B (P1CM;中间有液化；小淋巴结成串皆考虑为转移淋巴结，按92福州分期确定III/IVa期，KPS评分80分。舌脉变化是受检者在 自然 光线下，自然伸舌，时间不超过3秒，由二位放疗科医师和一名中医师按照全国癌症中医诊断协作组的标准和要求进行确定：正常：舌下2条静脉隐现于舌下，整条舌下静脉无扭曲、怒张，颜色淡紫。异常(+)：主干饱满，轻度弯曲，颜色红紫,异常(?)：主干直径增粗较明显，轻度弯曲，颜色青紫。异常(?)：主干饱满，曲张明显，颜色紫黑，外带有粗支状分枝或鱼子酱刺1，每例患者以治疗前

7、、中、后3次检查结果决定临床观察分组。1?2 一般资料 68例局部晚期鼻咽癌分为A组（舌脉正常组）和B组（舌脉异常组），两组资料，无统计学上差异。1?3 治疗方法 A组、B组全部进入同步放化疗，具体治疗方法：先行面颈联合野和下颈部切线野常规分割放疗DT3600CGY/18F 6MV X 线后，分为鼻咽癌颅底未侵犯的患者为二耳前野鼻前野放疗加量DT2400CGY/12F 6MV X线，鼻咽癌颅底侵犯，则二耳前野放疗加量DT2400CGY/12 F 6MV X线，颅底野加量DT400 CGY/2 F 6MV X线，上颈部先大野9MEV-12MEV 电子 线加量DT2000CGY/11F，再缩野淋巴结阳性区域加量DT1000CGY/6F，下颈部亦先大野9MEV-12MEV电子线加量DT1800CGY/11F，再缩野淋巴结阳性区域加量DT1200CGY/7F，放疗的第1天、第29天加用DDP40mg d1-3CF 200 d1-35-Fu 500mg d1-3，放疗结束后一周开始继续二疗程的DDP40mg d1-3CF 200 d1-35-Fu 750mg d1-3，放化疗后三月复查鼻咽部及颈部MRI，鼻咽部控制而颈部肿块3CM，穿刺证实有癌行同侧颈部清扫术。 关键词:疗效,分析,治疗,变化,局部,医学论文,局部晚期鼻咽癌舌脉变化与治疗疗效分析 内容摘要