發(fā)布時間：2018-02-02 22:02

  本文關(guān)鍵詞： 鼻咽癌 放射治療 三維適形放療 適形調(diào)強放療 圖像引導(dǎo)放療 容積調(diào)強放療 同步放化療　出處：《蚌埠醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：背景:我國是世界各大洲中鼻咽癌的高發(fā)地區(qū)之一。由于鼻咽部位較深,且鼻咽周圍有許多重要血管神經(jīng),頸淋巴結(jié)和遠處器官轉(zhuǎn)移率高,使得手術(shù)治療受到限制,目前鼻咽癌公認有效的治療手段為放療。早期的鼻咽癌患者采用單純放射治療有較理想的效果,中晚期患者由于較高的局部復(fù)發(fā)率和遠處轉(zhuǎn)移率導(dǎo)致總生存率明顯降低。同步放化療作為一種綜合治療的方式,已成為鼻咽癌的常規(guī)治療手段。本文就目前鼻咽癌同步放化療的研究進展情況進行綜述。目的:通過閱讀國內(nèi)外近年來鼻咽癌同步放化療的相關(guān)文獻,從鼻咽癌同步放化療的理論依據(jù)、臨床療效、同步放化療中放療技術(shù)的進展、同步放化療中化療時間和方案的選擇及同步放化療的毒副作用幾個方面來研究鼻咽癌同步放化療的臨床治療優(yōu)勢和缺陷,以進一步提高對鼻咽癌同步放化療的認識,尋求更加合理規(guī)范且療效最佳的同步放化療方案,以期進一步改善患者的生存及預(yù)后。方法:使用中國知網(wǎng)、萬方數(shù)據(jù)庫、Pubmed檢索系統(tǒng),以“鼻咽癌;放射治療;三維適形放療;適形調(diào)強放療;圖像引導(dǎo)放療;容積調(diào)強放療;同步放化療”做為關(guān)鍵詞,分別及聯(lián)合檢索文獻。綜合分析研究符合研究目的的52篇國內(nèi)外文獻。結(jié)果:大量臨床研究結(jié)果顯示出同步放化療在鼻咽癌治療中有著無可比擬的優(yōu)勢,多數(shù)文獻顯示其能提高局部控制率和總生存率、減少遠處轉(zhuǎn)移、降低復(fù)發(fā),雖然毒副反應(yīng)增加,但多數(shù)患者尚可耐受。結(jié)論:同步放化療在鼻咽癌的治療中顯示了無可比擬的優(yōu)勢,放療技術(shù)的不斷進步和越來越多新興化療藥物的出現(xiàn)為同步放化療開拓了廣闊的前景,但仍然缺少一個標準的放化療聯(lián)合模式,如何進一步提高同步放化療的臨床療效和減輕其毒副反應(yīng),達到進一步提高鼻咽癌患者生存質(zhì)量和預(yù)后的目的,還有待更多的大樣本臨床試驗加以完善。
[Abstract]:Background: China is one of the regions with high incidence of nasopharyngeal carcinoma on every continent in the world. Because of the deep nasopharynx and many important vessels and nerves around the nasopharynx, the cervical lymph node and distant organ metastasis rate is high. At present, radiotherapy is considered to be an effective treatment for nasopharyngeal carcinoma. Radiotherapy alone in early nasopharyngeal carcinoma patients has an ideal effect. The overall survival rate was significantly decreased due to the high local recurrence rate and distant metastasis rate in the middle and late stage patients. Simultaneous radiotherapy and chemotherapy as a comprehensive treatment. It has become a routine treatment for nasopharyngeal carcinoma. This article reviews the progress of simultaneous radiotherapy and chemotherapy for nasopharyngeal carcinoma. Objective: to review the literature on simultaneous radiotherapy and chemotherapy of nasopharyngeal carcinoma at home and abroad in recent years. According to the theoretical basis of simultaneous radiotherapy and chemotherapy for nasopharyngeal carcinoma, the clinical efficacy, and the progress of radiotherapy in simultaneous radiotherapy and chemotherapy. To study the advantages and disadvantages of simultaneous radiotherapy and chemotherapy in nasopharyngeal carcinoma (NPC), the selection of time and scheme of chemotherapy and chemotherapy and the side effects of concurrent radiotherapy and chemotherapy were used to study the advantages and disadvantages of simultaneous radiotherapy and chemotherapy in nasopharyngeal carcinoma (NPC). In order to further improve the understanding of nasopharyngeal carcinoma synchronous radiotherapy and chemotherapy, to seek a more reasonable standard and the best curative effect of simultaneous radiotherapy and chemotherapy regimen, in order to further improve the survival and prognosis of patients. Wanfang database, Pubmed search system, was used to "nasopharyngeal carcinoma (NPC);" Radiotherapy; Three dimensional conformal radiotherapy; Conformal intensity modulated radiotherapy; Image guided radiotherapy; Volume intensity modulated radiotherapy; Simultaneous radiotherapy and chemotherapy as a key word. Results: a large number of clinical studies showed that simultaneous radiotherapy and chemotherapy had unparalleled advantages in the treatment of nasopharyngeal carcinoma. Most literature shows that it can improve the local control rate and overall survival rate, reduce distant metastasis, reduce recurrence, although the side effects increased. Conclusion: simultaneous radiotherapy and chemotherapy have unparalleled advantages in the treatment of nasopharyngeal carcinoma. The continuous progress of radiotherapy technology and the emergence of more and more new chemotherapeutic drugs have opened up a broad prospect for simultaneous radiotherapy and chemotherapy, but there is still a lack of a standard combination mode of radiotherapy and chemotherapy. How to further improve the clinical efficacy of concurrent radiotherapy and chemotherapy and reduce its toxicity and side effects to further improve the quality of life and prognosis of patients with nasopharyngeal carcinoma, there are still more large samples of clinical trials to be improved.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R739.63

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本文編號：1485580