摘要目的：观察比较调强放疗联合化疗与单纯调强适形放疗治疗鼻咽癌的临床疗效、急性反应及晚期损伤。方法选择2009年1月至2013年1月胶州市人民医院收治的局部区域晚期Ⅲ～Ⅳa期鼻咽癌患者100例，将其随机分为观察组和对照组，各50例。对照组接受单纯根治性放疗+序贯化疗，观察组接受同步放化疗+序贯化疗。鼻咽和颈部靶体积均采用调强适形放疗（IMRT）技术照射。采用SPSS 20.0软件进行统计学分析，选择χ2检验，对两组患者术后的治疗情况以及并发症发生情况进行观察和比较。结果观察组患者的疗效优于对照组患者，两组比较差异有统计学意义，在急性损伤和慢性损伤方面，对照组患者的发生率少于观察组患者，但差异无统计学意义。结论调强放疗联合化疗与单纯调强化疗相比，前者在局部淋巴结转移与死亡率方面优于后者；在急性损伤与晚期损伤方面无差别，基于目前证据，调强联合化疗是一种值得临床推荐的方法。

abstractsObjectiveTo investigate the differences in efficacy, survival outcomes, and acute and late toxicities for patients with local/regional advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) in combination with chemotherapy (CT) and by IMRT alone.Methods From January 2009 to January 2013,Early to treat 100 cases of patients with nasopharyngeal carcinoma (NPC), are all Ⅲ ~ Ⅳ a period; Random accept radical therapy alone + sequential chemotherapy (50 cases) and sequential chemotherapy (50 cases). Nasopharynx and neck target volume adopts intensity modulated conformal radiotherapy, intensity modulated radiation therapy, IMRT) technology. On two groups of patients with postoperative treatment and complications after take rate, according to two groups compared withχ2 test, Software SPSS 20.0 was used for statistical analysis.Results The group of IMRT + CT is better than that of patients with IMRT about the acute complications, the more similar between the two groups have statistical significance, in terms of acute injury and chronic injury, the effect is better than that of IMRT + CT IMRT patients, but there was no statistically significant difference. For the adverse reaction of chemotherapy, lower incidence of IMRT + CT patients IMRT group, the difference was statistically significant.Conclusions Intensity-modulated radiation therapy compared with pure intensity-modulated chemotherapy with combination chemotherapy, the former is superior to the latter in terms of local lymph node metastasis and mortality; Difference in late acute injuries and damage, based on current evidence, intensity-modulated MDT is a worth clinical recommendations.