8结语 单纯化疗极难治愈鼻咽癌，与放疗同期进行可提高局部晚期者总生存率，同期放化疗可望成为中晚期鼻咽癌的标准治疗手段。含铂方案是目前最有效的组合方案，但含铂方案的药物组合、剂量及周期没有形成标准。新辅助化疗和辅助化疗是否提高生存率尚无定论，有待于大规模的随机对照研究。同期放化疗加辅助化疗生存率的改善是单纯得益于同期放化疗，还是两者有协同作用，这需要与同期放化疗对比研究，才能明确。分子靶向药物与放疗组合是否带来增益，须进一步探讨。
【参考文献】 ［1］MaJ,MaiHQ,HongMH,etal.Resultsofaprospectiverandomizedtrialcomparingneoadjuvantchemotherapyplusradiotherapywithradiotherapyaloneinpatientswithlocoregionallyadvancednasopharyngealcarcinoma［J］.JClinOcol，2001，19（5）:1350-1357. ［2］KawashimaM,FuwaN,MyojinM,etal.Amulti-institutionalsurveyoftheeffectivenessofchemotherapycombinedwithradiotherapyforpatientswithnasopharyngealcarcinoma［J］.JpnJClinOncol，2004,34（10）:569-583. ［3］ChanAT,TeoPM,NganRK,etal.Concurrentchemotherapyradiotherapycomparedwithradiotherapyaloneinlocoregionallyadvancednasopharyngealcarcinoma:progressionfreesurvivalanalysisofaphaseⅢrandomizedtrial［J］.JClinOncol,2002,20（8）:2038-2044. ［4］ChanAT,LeungSF,NganRK,etal.Overallsurvivalafterconcurrentcisplatin-radiotherapycomparedwithradiotherapyaloneinlocoregionallyadvancednasopharyngealcarcinoma［J］.JNatlCancerInst,2005,97（7）:536-539. ［5］LinJC,JanJS,HsuCY,etal.PhaseⅢstudyofconcurrentchemoradiotherapyversusradiotherapyaloneforadvancednasopharyngealcarcinomapitiveeffectonoverallandprogression-freesurvival［J］.JClinOncol,2003,21（4）:631-637. ［6］ZhangL,ZhaoC,PengPJ,etal.PhaseⅢstudycomparingstandardradiotherapywithorwithoutweeklyoxaliplatinintreatmentoflocoregionallyadvancednasopharyngealcarcinomapreliminaryresults［J］.JClinOncol,2005,23（33）:8461-8468. ［7］王秀清,李靖松,吴尚,等.同期放化疗治疗局部晚期鼻咽癌的临床研究［J］.中华医学杂志，2007,31（4）:292-295. ［8］Al-SarrafM,LeBlancM,GiriPGS,etal.ChemotherapyversusradiotherapyinpatientswithadvancednasopharyngealcancerphaseⅢrandomizedIntergroupStudy0099［J］.JClinOncol,1998,16（4）:1310-1317. ［9］LeeAW,TungS,ChuaD,etal.ProspectiverandomizedstudyontherapeuticgainachievedbyadditionofchemotherapyforT1-4N2-3M0nasopharyngealcarcinoma（NPC）［abstract5506］.ProcAmSocClinOncol,2004,23:487. ［10］胡巧英,刘鹏,王磊,等.Ⅲ、Ⅳa期鼻咽癌患者放疗同期化疗加辅助化疗的疗效［J］.癌症,2007,26（4）:394-397. ［11］AbdullahAL,NasserAL,YasserK,etal.Neoadjuvantchemotherapyfollowedbyconcurrentchemo-radiationtherapyinlocallyadvancednasopharyngealcarcinoma［J］.IntJRadiatOncolBiolPhys,2005,62（2）:508-513. ［12］OhJL,VokesEE,KiesMS,etal.Inductionchemotherapyfollowedbyconcomitantchemoradiotherapyinthetreatmentoflocoregionallyadvancednasopharyngealcancer［J］.AnnOncol,2003,14（4）:564-569. ［13］FounlzilasG,TolisC,KalogeraFA,etal.Inductionchemotherapywithcisplatin,epirubicin,andpaclitaxel（CEP）,followedbyconcomitantradiotherapyandweeklypaclitaxelforthemanagementoflocallyadvancednasopharyngealcarcinoma［J］.StrahlentherOnkol,2005,181（4）:223-230. ［14］高剑铭,梁颖,胡伟汉,等.诱导化疗联合同期放化疗对局部晚期鼻咽癌的远期疗效［J］.癌症,2007,26（8）:885-889. ［15］伍尤华,唐三元.放化疗序贯治疗晚期鼻咽癌的前瞻性研究［J］.南华大学学报：医学版，2007,35（4）：541-547. ［16］蔡长青,廖万清,刘文哲,等.新辅助化疗后放射治疗≥N2期鼻咽癌的远期临床疗效［J］.中国医疗前沿,2007（2）:8-9. ［17］ChuaDTT,ShumJST,WeiWI,etal.Controlofregionalmetastasisafterinductionchemotherapyandradiotherapyfornasopharyngealcarcinoma［J］.HeadNeck,2002,24（4）:350-360. ［18］HareyamaM,SakataK,ShiratoH,etal.Aprospectiverandomizedtrialcomparingneoadjuvantchemotheapywithradiotherapyaloneinpatientswithadvancednasopharyngealcarcinoma［J］.Cancer,2002,94（8）:2217-2223. ［19］MaJ,MaiHQ,HongMH,etal.Resultsofaprospectiverandomizedtrialcomparingneoadjuvantchemotherapyplusradiotherapywithradiotherapyaloneinpatientswithlocoregionallyadvancednasopharyngealcarcinoma［J］.JClinOcol,2001,19（5）:1350-1357. ［20］唐天友,周凤娟,王建设,等.中晚期鼻咽癌新辅助化疗联合放疗的临床研究［J］.现代肿瘤医学，2006,14（12）:1507-1509. ［21］El-WeshiA,KhafagaY,AllamA,etal.NeoadjuvantchemotherapyplusconventionalradiotherapyoracceleratedhyperfractionatedinstageⅢandⅣnasopharyngealcarcinomaphaseⅡstudy［J］.ActaOncol,2001,40（5）:574-581. ［22］GardenAS.Istherestillaroleforinductionchemotherapyforheadandneckcancer［J］.JClinOncol,2005,23（6）:1059-1060. ［23］RsiA,MolinariR,BoracchiP,etal.Adjuvantchemotherapywithvincristine,cycliphphamideanddoxorubicinafterradiotherapyinlocalregionalnasopharyngealcancer:resultsofa4-yearmulticenterrandomizedstudy［J］.JClinOncol，1988，6（9）：1401-1410. ［24］ChiKH,ChangYC,GuoWY,etal.AphaseⅢstudyofadjuvantchemotherapyinadvancednasopharyngealcarcinomapatients［J］.IntJRadiatOncolBiolPhys,2002,52（5）:1238-1244. ［25］黄慧强.鼻咽癌化疗的研究进展［J］.广东医学,2002,23（4）:335-337. ［26］彭玉龙,庞伟,陈荣辉,等.艾素联合化疗方案治疗鼻咽癌的临床观察［J］.实用临床医学，2006,7（5）:20-21. ［27］ChanAT,HsuMM,GohBC,etal.MulticenterphaseⅡstudyofCetuximabincombinationwithcarboplatininpatientswithrecurrentormetastasisnasopharyngealcarcinoma［J］.JClinoncol,2005,23（15）:3568-3576.
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