The Effect of Adjuvant Chemotherapy for Nasopharyngeal Carcinoma: a Preliminary Report

在過去的年代，放射治療一直是鼻咽癌最主要的治療方式，但是遠處轉移也一直是造成鼻咽癌病人死亡的最大因素，因此合併使用引導性化學療法，已變成一種趨勢。在本研究裡，我們把病人分成兩組：第一組46人，先使用Cisplatin+5-FU治療，然後再加上放射治療；第二組49人，只給予一般的放射治療。化學療法的副作用，除了兩例因分別是頑固性嘔吐及半昏迷而中止治療外，一般皆可承受。有17例發生白血球過少症及一例血中尿素氮輕微上升。所有病例的血小板及血清肌酸酐皆在正常範圍。鼻咽癌原發處，其接受化學療法後的完全反應率（complete response）為22.7%，部份反應率（partial response）為50%，總共反應率為72.7%。頸部轉移處，其完全反應率為56.7%，部份反應率為23.3%，總共80%。然而加上化學治療後，其原發處反應率雖然為97.7%，但比起單獨放射治療組的87.8%，卻沒有統計上之意義。而頸部轉移處，兩組的反應率亦無統計上之意義。在病理分類中，非角質化型佔36.4%，未分化型佔56.8%，總共93.2%，符合中國人的報告。此兩者間其對化學療法的反應率有統計上之意義。化學療法對鼻咽癌的反應率雖很好，副作用也很少，但對存活率是否有改善，仍須長期的觀察。

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並列摘要

In the past, radiation therapy was the main treatment modality in nasopharyngeal cancer, but recently, combined induction chemotherapy has become a trend. In this study patients with NPC were divided into two groups. Group I, 46 cases were treated with chemotherapy (Cisplatin + 5 – Fu) and radiation. In Group II, 49 cases were given radiation only. The side effects of chemotherapy were tolerable except for 2 dropouts due to intractable vomiting and semicoma respectively. Only 17 cases got leucopenia and one case was graded I in BUN evaluation. All of the cases were within normal limits in the platelet and creatinine evaluation. Nine cases acquired hyponatremia. The response rate was 72.7% in the primary site which included 22.7% of the complete response and 50.0% of the partial response with a 80.0% response rate in neck site, which included 56.7% of complete respone and 23.3% of partial response. But after the consecutive radiation, the differences of response rate did not show any significance between the two groups. The difference in the response rate between non-keratinizing and undifferatiated carcinoma were significant.

並列關鍵字

nasopharyngeal cancer ； chemotherapy

國際替代計量

The Effect of Adjuvant Chemotherapy for Nasopharyngeal Carcinoma: a Preliminary Report

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