紫杉醇+顺铂诱导化疗晚期鼻咽癌的近期疗效  

Paclitaxel+Cisplatin Chemotherapy in Advanced Nasopharynx Carcinoma

作　　者：杨凌[1] 林色南[1] 张瑜[1] 郑威[1] 郑茁[1] 潘建基[1] 

机构地区：[1]福建医科大学教学医院福建省肿瘤医院放疗科,福州350014

出　　处：《福建医科大学学报》2005年第4期429-431,共3页Journal of Fujian Medical University

摘　　要：目的探讨紫杉醇+顺铂及5-氟尿嘧啶(5-Fu)+顺铂方案诱导化疗晚期鼻咽癌的临床疗效及不良反应.方法Ⅲ～Ⅳa期鼻咽癌患者291例随机分为紫杉醇+顺铂+放疗(紫杉醇组)、5-Fu+顺铂+放疗(5-Fu组)以及单纯放疗三组.诱导化疗药用量:紫杉醇100～120 mg·m-2·d-1,顺铂80 mg·m-2·3d-1,5-Fu 0.5～0.75g·m-2·d-1×3 d;第15天重复以上剂量的化疗周期,第18天即开始放疗.放疗采取Co60或(和)X线6 MV常规照射,鼻咽部总剂量约DT 70 Gy/35次/7周.结果紫杉醇组与5-Fu组鼻咽及颈部肿瘤消失的平均剂量均小于单纯放疗组(P＜0.01);3组临床肿瘤全消率分别为87.3%,76.9%和58%(P＜0.01).不良反应主要为粒细胞下降、脱发、日腔黏膜反应及胃肠道反应,均能耐受.结论紫杉醇+顺铂及5-Fu+顺铂短程诱导方案对晚期鼻咽癌均能加快肿块消失及提高肿瘤消失率.紫杉醇方案主要副作用为粒细胞下降及脱发;5-Fu方案主要副作用为口腔黏膜反应及胃肠道反应.Objective To study the clinical results and side effects of with paclitaxel ＋ cisplatin and 5-fluorouracil（5-Fu） ＋ cisplatin in advanced carcinoma of nasopharynx （NPC）. Methods 291 cases of NPC stage Ⅲ -Ⅳa were enrolled. They were randomly divided into three groups, paclitaxel ＋ cisplatin and radiotherapy, 5-Fu ＋ cisplatin and radiotherapy and simple radiotherapy. The dosages of paclitaxel 100-120 mg·m^-2·d^-1/d,cisplatin 80 mg·m^-2·d^-1×3 d, 5-Fu0.5-0.75mg·m^-2·d^-1×3d, three days as one cyele. There were 11 days between two cycles. Radiotherapy followed two cycles of chemotherapy. Results The mean dosages of irradiation that makes nasopharyngeal tumor or cervical mass disappeared in chemotherapy groups were lower than that in simple radiotherapy group（P 〈 0. 001）. Clinical tumor entirely disappeared rates were 87.3%, 76.9% and 58% in paclitaxel, 5-Fu and simple group respectively（P〈0.01）. Side effects include granulocytopenia, baldness, oral mucitis and gastro-intestinal effects, and they could be endured, Conclusion Short-termed induced remedies with paclitaxel ＋ cisplatin and 5-Fu ＋ cisplatin can accelerate the disappearance of tumors, and improve the disappearance rates. Side effects mainly include granulocytopenia and baldness in paclitaxel group, oral mucitis and gastro-intestinal effects in 5-Fu group.

关 键 词：鼻咽肿瘤 化学疗法 放射疗法 紫杉醇 

分 类 号：R739.63[医药卫生—肿瘤]