放疗联合奈达铂每周用药治疗局部中晚期鼻咽癌的临床观察  

Efficiency and toxicity of radiotherapy combined with weekly nedaplatin in the treatment of locally advanced nasopharyngeal carcinoma

作　　者：舒中琴[1] 茅卫东[1] 夏林云[1] 林峰[1] 

机构地区：[1]东南大学医学院附属江阴医院,江阴214400

出　　处：《中国新药杂志》2010年第20期1875-1878,共4页Chinese Journal of New Drugs

摘　　要：目的:观察放疗同步奈达铂每周给药治疗局部中晚期鼻咽癌的近期疗效及毒副反应。方法:将局部中晚期鼻咽癌随机分为治疗组和对照组,治疗组在放疗同时予以单药奈达铂(NDP)40 mg.m-2,每周1次,共7次,对照组为顺铂(DDP)40 mg.m-2,每周1次,共7次,均在放疗d 1用药。两组放疗方法相同,剂量相似,放疗结束后均予4周期TP方案(紫杉醇+顺铂)化疗。结果:放疗结束后3月评价近期疗效,NDP组和DDP组鼻咽部病灶完全消退率分别为88.9%和92.6%;颈部淋巴结完全消退率分别为92.6%和96.3%,两组比较差异无统计学意义(P>0.05);NDP组胃肠道反应发生率(7.1%)显著低于DDP组(64.3%)(P<0.05);两组白细胞下降发生率分别为57.1%和53.8%,差异无统计学意义(P>0.05),血小板下降发生率NDP组(42.9%)较DDP组(17.9%)高,差异有统计学意义(P<0.05)。结论:放疗联合NDP每周给药治疗局部中晚期鼻咽癌与联合DDP相比,近期疗效相当,但NDP治疗组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。Objective： To observe the efficiency and toxicity of radiotherapy combined with weekly nedaplatin in the treatment of locally advanced nasopharyngeal carcinoma.Methods： Totally 56 patients with locally advanced nasopharyngeal carcinoma were randomly divided into 2 groups.They were treated with nedaplatin（NDP） 40 mg·m^-2,weekly for 7 weeks,or with cisplatin（DDP） 40 mg·m^-2,weekly for 7 weeks（control）.The medications started on the first day of radiotherapy with same radiotherapy method and dose.After radiotherapy,all patients were treated with 4 cycle chemotherapy of TP（taxol＋cisplatin） regimen.Results： The efficiency was evaluated 3 months after radiotherapy.The complete response rates in nasopharynx were 88.9% and 92.6%,respectively,in NDP and DDP groups;the complete response rates in cervical lymph node were 92.6% and 96.3%,respectively;no significant differences（P〉0.05） between the two groups were found in these rates.The incidence rate of gastrointestinal reactions in NDP（7.1%） group was significantly lower than that in DDP group（64.3%,P〈0.05）.The incidence rates of leukocytopenia were 57.1% and 53.8%（P〉0.05）.The incidence rate of thrombocytopenia in NDP group（42.9%） was significantly higher than that in DDP group（17.9%,P〈0.05）.Conclusions： The short-term efficiency and toxicity of radiotherapy combined with weekly nedaplatin（NDP） in the treatment of locally advanced nasopharyngeal carcinoma are equivalent to those of DDP,but NDP has fewer gastrointestinal tract reactions and its main toxicity is thrombocytopenia.

关 键 词：奈达铂 顺铂 鼻咽癌 放射治疗 同期放化疗 

分 类 号：R979.1[医药卫生—药品]