Clinical Analysis Of Re-Irradiation Plus CMNA To Recurrent Nasopharyngeal Carcinoma

Object To compare the difference of the local control rate, relapse, free-relapse survival period, total survival period, and acute and late-reactions of radiotherapy of normal tissues (or critical organs), quality of life between re-irradiation plus sodium glycidizole(CMNa) and re-irradiation alone to recurrent nasopharyngeal carcinoma, and then to select the best method of treatment of recurrent nasopharyngeal carcinoma for clinical medecine.Method of research From December 2000 to December 2002, 60 patients with pathologically comfirmed recurrent nasopharyngeal carcinoma were randomized to be assigned into group A treated with re-irradiation plus CMNa or group B with re-irradiation alone. Both groups were treated with pre-auride field by 6MV X rays, the dosage of radiotherapy was 60-70GY/30-35fractions/42days-49days. The group A was given CMNa 800mg/m~2 iv drip in 30 minutes before radiotherapy and the group B was given NS three times per week during the whole period of radiotherapy.Results The acute reactions of normal tissues including digestive reaction, oral epidermis reaction, bone marrow inhibition, and the hepatic and renal function in both groups had no change. No nervous system adverse reaction was observed. The late radiotherapic reactions were not significally different. The local control rates for group A and B were 76.7% (23/30) and 50% (15/30) respectively, P=0.032. The average relapse-free survival periods, total average survival periods for group A and B were 33. 9±6. 67 months and 20.13±7. 25 months, P=0. 02, 38.83±6.32 months and 24.10±7.18 months, P=0.029 respectively. There were no significally different in the quality of life between group A and B, but the quality of life in the same group reduced with time. Conclusions The clinical data of the two groups before test were comparable. We can well find that CMNA plus radiotherapy is better than radiotherapy alone on the hands of local control rate, relapse-free period, and total survival period. Sodium glycididarole is well tolerable effective as a hypoxic radiosensitizer, which can improve the efficacy of radiotherapy, but no significant adverse effect.