局部晚期鼻咽癌舌脉变化与治疗疗效分析_临床医学论文.docVIP

局部晚期鼻咽癌舌脉变化与治疗疗效分析_临床医学论文 局部晚期鼻咽癌舌脉变化与治疗疗效分析_临床医学论文 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％、47％，组间差别无统计学意义；A组、B组五年无远处转移率分别为75％、60％，A组显著高于B组（0）。［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 carcinoma, 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 nasopharyngeal 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 radiotherapy, patients were received two cycles chemotherapy again. The 5year overall survival rates and free distant metastases rate were observed.［Results］ The 5ith 605% in arm B (005). ［Conclusion］ The glossal venation abnormal or not was no significant effect in 5bly. It suggested that the change of glossal venation of patients with NPC would be one of indexes to estimate the distant metastases. 　　Key words:nasopharyngeal carcinoma;tongue vein;concurrent radiotherapy and chemico 　　局部晚期鼻咽癌虽通过放疗和化疗的综合应用，5年生存率仍徘徊在25%~50％，局部晚期鼻咽癌患者预后差的主要原因是肿瘤局部未控复发及远处转移，其中局部未控复发占34％，远处转移占45％, 临床治疗过程中这就需要一直观指标能对整体治疗疗效作出初步判断和改进治疗方法，舌脉变化观察系中医传统四诊中重要内容，与癌症的关系和预后有相关性，本文观察68例局部晚期鼻咽癌舌脉变化与治疗疗效，现报道如下。 　　1 材料和方法 　　1入选条件 1997年8月~2001年8月68例进入同步放化疗的局部晚期鼻咽癌，治疗前病理证实为低分化鳞癌，既往无放疗和化疗史，入组前患者查B超、胸片及`骨ECT排除远处转移，行鼻咽