泰素帝联合顺铂(TP)与顺铂联合5-FU(PF)方案治疗局部晚期鼻咽癌的比较  

Comparison of Efficacy of Docetaxel Combined Cisplatin (TP Regimen) and Cisplatin Combined 5-Fluorouracil (PF Regimen) on Locally Advanced Nasopharyngeal Carcinoma

作　　者：谢方云[1] 亓姝楠[1] 胡伟汉[1] 邹国荣[1] 彭苗[1] 李济时[1] 

机构地区：[1]华南肿瘤学国家重点实验室

出　　处：《癌症》2007年第8期880-884,共5页Chinese Journal of Cancer

摘　　要：背景与目的:泰素帝、顺铂是治疗头颈部肿瘤有效的单药,泰素帝+顺铂(TP)方案联合放疗用于头颈部肿瘤的治疗已完成Ⅱ～Ⅲ期临床试验。本研究通过对比顺铂联合氟尿嘧啶(5-FU)(PF)方案与TP方案对鼻咽癌患者的反应率和毒副反应,探讨局部晚期鼻咽癌患者同期化疗新的化疗方案。方法:自2005年10月1日至2006年3月31日中山大学肿瘤防治中心放疗科二区鼻咽癌住院患者符合入组标准的20例进入试验组(TP组)。自2004年3月至2005年9月30日期间符合入组条件的PF方案诱导+同期放化疗的45例病例中随机抽取20例作为对照组(PF组)。分别比较两组患者诱导化疗与同期放化疗的近期疗效和不良反应。结果:与PF方案相比,TP方案诱导+同期放化疗实施的平均化疗周期数多(3.85vs.2.75,P=0.000)。诱导化疗后,TP组鼻咽病灶部分缓解(partialremission,PR)18例,稳定(stable disease,SD)2例;颈淋巴结完全缓解(complete remission,CR)7例,PR11例,SD2例。PF组鼻咽病灶PR17例,SD3例;颈淋巴结CR2例,PR15例,SD1例。两组对比差异无统计学意义(P>0.05)。同期放化疗结束后评价,试验组鼻咽灶均达CR,对照组18例达CR;颈淋巴结试验组19例CR,对照组15例CR,残留病灶经进一步处理后无增大或复发。试验组和对照组诱导化疗Ⅲ度及Ⅲ度以上中性粒细胞减少的发生率分别为40.5%和0%;同期放化疗Ⅲ度及Ⅲ度以上中性粒细胞减少的发生率分别为40.5%和10.2%,两组比较差异有统计学意义(P<0.05),但贫血与血小板减少发生率低(P<0.05)。两者在抗生素使用及静脉营养支持上差异皆无统计学意义(P>0.05)。结论:TP方案治疗鼻咽癌的近期疗效与PF方案相似,不良反应可耐受,远期疗效与毒性尚需进一步研究。BACKGROUND ＆ OBJECTIVE： Docetaxel and cisplatin （DDP） are effective drugs for head and neck tumors. Stage Ⅱ - Ⅲ clinical trial of TP regimen （docetaxel combined DDP） for head and neck tumors has completed. This study was to compare the efficacy and toxicity of TP regimen and PF regimen [DDP combined 5-fluorouracil （5-FU）] in treating nasopharyngeal carcinoma （NPC）, to provide a new chemotherapeutic regimen for NPC. METHODS： Twenty NPC patients treated in Cancer Center of Sun Yat-sen University between Oct. 1, 2005 and Mar. 1, 2006 were subjected to study group （TP group）. Twenty patients were chosen randomly from the 45 NPC patients treated with PF regimen between May 1, 2004 and Sep. 30, 2005 as control group （PF group）. Both groups received concurrent radiotherapy. The efficacy and adverse events of the 2 groups were compared. RESULTS： The mean number of chemotherapy cycles was significantly higher in TP group than in PF group （3.85 cycles vs. 2.75 cycles, P〈0.001）. After induction chemotherapy, in TP group, 18 achieved partial remission （PR） and 2 had stable disease （SD） for nasopharyngeal lesions, 7 achieved complete remission （CR）, 11 achieved PR and 2 had SD for regional lymph nodes; in PF group, 17 achieved PR and 3 had SD for nasopharyngeal lesions, 2 achieved CR, 15 achieved PR and 1 had SD for regional lymph nodes. After concurrent chemoradiotherapy, all in TP group and 18 in PF group achieved CR for nasopharyngeal lesions, and 19 in TP group and 15 in PF group achieved CR for regional lymph nodes. There was no significant difference in efficacy between the 2 groups （P〉0.05）. The occurrence rates of grade 3-4 neutropenia were significantly higher in TP group than in PF group （40.5% vs. 0% after induction chemotherapy, 40.5% vs. 10.2% after concurrent radiochemotherapy, P〈0.05）. The occurrence rates of anemia and thrombocytopenia were significantly lower in TP group than in PF group （P〈0.05）. The uses of antibiotics and parenteral nu

关 键 词：鼻咽肿瘤 化学疗法 放射疗法 顺铂 泰素帝 氟尿嘧啶 疗效 不良反应 

分 类 号：R739.63[医药卫生—肿瘤]