A Clinic Analysis Of Multidisciplinary Management Effecs Of Patients With Nasopharygeal Carcinoma

ObjectiveTo evaluate effects of patients with nasopharygeal carcinoma treated by multidisciplinary management.MethodsTotal 157 cases of patients with advanced nasopharyngeal carcinoma(â…¢,â…£a,92 Fuzhou)were treated with multidisciplinary management from January 2000 to February 2002,71 accepted radiotherapy (RT)followed by adjuvant chemotherapy(Group A) , 86 accepted neoadjuvant plus adjuvant chemotherapy(Group B).Methods of radiotherapy: All patients were treated by radiotherapy by 60Co or 6MV X-ray,2Gy/F,5F/W. The total dose was 70Gy in the primary tumor of nasopharynx,50~60Gy in neck,boosting 6-10Gy in the residual site. Methods of chemotherapy: patient in group A was given chemotherapy 1~2W past radiotherapy. Patient in group B was treated by 1~2 cycles chemotherapy before RT,then accepted chemotherapy after radiotherapy. Chemotherapy protocol: Pingyangmycin (PYM) ,Cisplatin (DDP) and 5-Fluorouracil(5-FU)(Protocol DPF)or DDP combined with 5-FU(Protocol PF).All patients have finished 4~6 cycles chemotherapy.ResultThe 5-year survival rate was 48.7 % in Group A,50.9 % in Group B.There was no significance between two groups(P>0.05). However, the 5-year survival rate ofâ…£a-stage patients was13.3 % in Group A and 30.0 % in Group B.The significance was distinct (P<0.01). The 5-year local control rate of nasopharyngeal tumor was 75.4 % in Group A and 74.3 % in Group B.The 5-year total control rate of neck lymph node was 49.1 % in Group A and 47.1 % in Group B. There was no significance(P<0.05).When the radiotherapy was finished,the complete remission rate was 83.1 % in Group A and 89.5 % in Group B. (P<0.05).The metastasis rate was 26.3 % in Group A and 18.6 % in Group B. (P<0.05).There was no significance in side effect between Group A and Group B.Stage was the most important prognosis factor.The prognosis of patients with different chemotherapy protocol was not different.ConclusionGroup B (neoadjuvant plus adjuvant chemotherapy) is better than group A(adjuvant chemotherapy) because of better 5-year survival rate ofâ…£a-stage patients,the complete remission rate and lower metastasis rate corresponding with similar locol control rate,side-effect.