拉米夫定预防鼻咽癌治疗相关性乙肝病毒再激活的疗效分析  

Analysis of efficacy in Lamivudine for preventing nasopharyngeal carcinoma-treated-related hepatitis B virus reactivation

作　　者：熊勇[1] 周同冲[2] 张伟军[2] 王兆武[2] 林晓丹[2] 王秀利[2] 宋先璐[2] 刘源[2] 石兴源[2] 廖志伟[2] 

机构地区：[1]广州医学院 [2]广州医学院附属肿瘤医院放疗科,510095

出　　处：《国际医药卫生导报》2010年第1期50-54,共5页International Medicine and Health Guidance News

摘　　要：目的探讨拉米夫定预防鼻咽癌治疗相关性乙型肝炎病毒再激活的疗效。方法收集2008年3月至2009年3月初治HBsAg(+)鼻咽癌患者51例,将其分成两组:拉米夫定预防治疗组(A组,n=26例)和非预防治疗组(B组,n=25例)。A组患者在鼻咽癌放化疗前一周开始口服拉米夫定100mg/d,至放化疗结束后8w;B组未给予预防性口服拉米夫定。比较两组鼻咽癌治疗相关性肝炎发生率、HBV再激活率及放化疗中断率。结果鼻咽癌放化综合治疗期间,预防治疗组和非预防治疗组治疗相关性肝炎发生率、HBV再激活率及放化疗中断率分别为3.85%与32%、0%与28%、19.2%与56%,两组比较差异有显著性(P值<0.05)。结论拉米夫定预防性治疗能够显著降低鼻咽癌治疗相关性肝炎的发生率、HBV再激活率及放化疗中断率。Objective To analyze the efficacy in Lamivudine for preventing nasopharyngeal carcinoma-treated-related hepatitis B virus reactivation.Ms, hods During the time from march 2008 to March 2009, Fifty-one patients with HBV were randomly divided into two groups.One group consisted with 26 patients who received prophylactic lamivudine prior to therapy and until 8 weeks after discontinuing concurrent chemoradiotherapy or chemotherapy.The other comprised 25 patients who did not undergo prophylactic lamivudine before therapy of NPC. The outcomes （incidences of hepatitis, HBV reactivation, disruption of chemo-radiotherapy therapy in NPC） were compared. Results With prophylactic lamivudine, there were significantly fewer incidences of hepatitis（3.85% vs 32%, P=0.023） and HBV reactivation （0% vs 28%, P=0.012）, and less disruption of chemotherapy（19.2% vs 56%, P=0.007）.Conclusions Prophylactic lamivudine significantly reduces the incidence of nasopharyngeal carcinoma-treated-related hepatitis and morbidity of HBV reactivation in NPC patients with HBV undergoing chemotherapy and radiotherapy.

关 键 词：鼻咽癌 乙肝病毒再激活 同期放化疗 拉米夫定 乙肝病毒 

分 类 号：R512.62[医药卫生—内科学] R739.63[医药卫生—临床医学]