奈达铂联合放疗治疗晚期鼻咽癌  

Nedaplatin combined with radiotherapy in the treatment of advanced nasopharyngeal carcinoma

作　　者：周翡[1] 罗金红[1] 王理伟[1] 

机构地区：[1]同济大学附属东方医院肿瘤内科,上海200120

出　　处：《中国癌症杂志》2007年第6期490-492,共3页China Oncology

摘　　要：背景与目的：鼻咽癌的标准治疗方法是放射治疗,但超过70%的患者确诊时已到晚期,单纯放疗后的局部复发率及远处转移率较高.放疗联合应用化疗可显著改善晚期鼻咽癌的疗效.因此本研究放疗联合含奈达铂（nedaplatin,NDP）化疗方案的新辅助化疗治疗晚期鼻咽癌的近期疗效和不良反应,以含顺铂（cisplatin,DDP）化疗方案作为对照组.方法：64例晚期鼻咽癌患者,随机分成奈达铂治疗组32例,顺铂对照治疗组32例.两组均在诱导化疗2个周期后行放射治疗.化疗方案：NDP 80 ms/m2,静滴,第1天,氟尿嘧啶（5-Fu）500 mg/m^2,静滴,第1～5天;DDP 40 mg/d,静滴,第1-3天,5-Fu 500 mg/m^2,静滴,第1-5天.放射治疗鼻咽部（7～9周）总剂量：66～74 Gy/（33～37）次;颈部淋巴结每（7～8.5周）总剂量：（60～70） Gy/（30～35）次;颈部预防剂量：（48～50）Gy.结果：NDP组有效率（56.25%）,DDP组有效率（50.00%）,差异无显著性（P＞0.05）;NDP组呕吐发生率（15.62%）显著低于DDP组（46.88%）（P＜0.01）;两组肾脏毒性差异无显著性;两组白细胞下降发生率分别为62.50%和56.25%,差异无显著性（P＞0.05）;血小板下降发生率NDP组（59.38%）较DDP组（31.25%）高,差异有显著性（P＜0.05）.结论：NDP治疗晚期鼻咽癌近期疗效与DDP相近,但NDP有较少的胃肠道反应发生,其毒副反应主要是骨髓抑制所致的血小板减少.Background and purpose： The standard therapy of nasopharyngeal carcinoma is radiation therapy, but more than 70% of patients are of advanced stage. Local recurrence and distant metastasis after radiotherapy only are high. Radiation therapy in combination with chemotherapy can significantly improve the efficacy of advanced nasopharyngeal carcinoma. This study was done to detect the efficacy and toxicity of the neoadjuavant chemotherapy for combined radiotherapy with china-made nedaplatin and cisplatin in the treatment of advanced nasopharyngeal carcinoma. Methods： A total of 64 patients with advanced nasopharyngeal carcinoma were randomized into the nedaplatin group （n = 32） and the DDP group （ n = 32）. The two groups of patients received two course of neoadjuvant chemotherapy before radiotherapy. Chemo-regime： nedaplatin 80 mg/m^2 d 1, 5-FU 500 mg/m^2 d 1-5, cisplatin 40 mg/d d 1-3. Radio-therapy： The NpDT and LNDT were 66- 74 Gy/（33-37 f）/（7-9 weeks）, 60-70 Gy/（30-35 f）/（7-8.5 weeks）, respectively. The prophylactic dose of neck was 48-50 Gy. Results： The efficacy of NDP group was 56.25% and DDP group was 50.00%. There was no significant difference between the two groups in curative effect （P 〉 0. 05）. NDP had lower reaction rate, vomiting （15.62%） occurred in NDP group, compared to that which occurred in DDP group （ 46.88% ）, with a significant difference between the two groups （ P 〈 0.01）. There was no significant difference between the two groups in the incidence of leukopenia （62.50%, 56.25%） and reaction rate of nephrotoxicity （6.25%, 9.38%）. There was a higher reaction rate of thrombocytopenia （59.38%） in NDP group than in DDP group （31.25%）, with a significant difference between the groups （P 〈 0. 05）. Conclusions： There is no significant difference between neda-platin and cisplatin regimens and there is a lower digestive reaction than in cisplatin group. Its main adverse reaction is myelosuppression, especially thrombocytopenia.

关 键 词：奈达铂 顺铂 鼻咽癌 放射治疗 新辅助化疗 

分 类 号：R739.6[医药卫生—肿瘤]