奈达铂或顺铂联合5-氟尿嘧啶治疗鼻咽癌的随机对照研究  

Nedaplatin or cisplatin combined with 5-fluorouracil for treatment of stage Ⅲ-Ⅳa nasopharyngeal carcinom：a randomized controlled study

作　　者：曹卡加[1] 张爱兰[1] 马文娟[1] 黄培钰[1] 罗东华[1] 夏伟雄[1] 

机构地区：[1]中山大学肿瘤防治中心鼻咽科华南肿瘤学国家重点实验室,广州510060

出　　处：《中华肿瘤杂志》2011年第1期50-52,共3页Chinese Journal of Oncology

基　　金：基金项目：“十一五”国家科技重大专项（2008zx09312-002）

摘　　要：目的 比较奈达铂联合5-氟尿嘧啶（5-Fu）与顺铂联合5-Fu诱导化疗治疗局部中晚期鼻咽癌的疗效和耐受性.方法 100例经病理组织学确诊的Ⅲ、Ⅳa期鼻咽癌患者随机分为奈达铂联合5-Fu组（NF组）和顺铂联合5-Fu组（PF组）,每组50例.NF组：奈达铂30 mg/m2,静脉滴注,第1～3天 5-Fu 500 mg/m2,静脉滴注,第1～5天,每3周重复,连续应用2个疗程.PF组：顺铂30 mg/m2,静脉滴注,第1～3天 5-Fu 500 mg/m2,静脉滴注,第1～5天,每3周重复,连续应用2个疗程.采用x2检验比较两组患者的疗效和急性不良反应.结果 50例患者均可进行疗效评价,两组患者的临床资料比较无明显差别.NF组和PF组患者肿瘤全消各3例.NF组的有效率为86.0%,PF组为84.0%,两组差异无统计学意义（x2=0.078,P=0.779）.PF组患者恶心、呕吐的发生率（88.0%）明显高于NF组（56.0%,x2=23.268,P=0.000） 两组患者外周血白细胞数、血小板数、谷丙转氨酶、尿素氮和肌酐异常的发生率比较,差异无统计学意义（P〉0.05）.结论 奈达铂联合5-Fu是治疗局部中晚期鼻咽癌的有效方案,有效率与PF方案相似.在减少恶心、呕吐方面,奈达铂联合5-Fu有明显的优势.Objective To compare the efficacy and side effects of nedaplatin plus 5-fluorouracil （5-Fu） and cisplatin plus 5-Fu for treatment of stage Ⅲ-Ⅳa nasopharyngeal carcinoma （NPC）.Methods A total of 100 patients with NPC proved by histopathology were divided into nedaplatin plus 5-Fu group （ NF group） and cisplatin plus 5-Fu group （PF group）, 50 cases in each group.NF group：nedaplatin 30 mg/m2,d1-d3, 5-Fu 500 mg/m2 d1-d5, repeated every 3 weeks for2 cycles.PF group：cisplatin 30 mg/m2 d1-d3, 5-Fu 500 mg/m2 d1-d5, repeated every 3 weeks for 2 cycles.x2 test was used to compare the efficacy and sideeffects of the two groups.Results All the 100 cases were evaluable and their clinical data in the two groups were comparable.Six patients with complete response were observed, 3 cases in NF group and 3 in PF group.The overall response rates were 86.0% in NF group and 84.0% in PF group, with no significant difference （x2 = 0.078, P = 0.779 ）.The rates of leukocytopenia, thrombocytopenia, impairment of hepatic and renal function were similar whereas more patients in the PF group than in the NF group suffered from nausea and vomiting （ 88.0% vs.56.0%, P = 0.000）.Conclusions Nedaplatin plus 5-Fu is an effective treatment regimen for NPC.When compared with PF regimen, the response rate is similar.However, NF regimen shows a significant superiority in reducing nausea and vomiting.

关 键 词：鼻咽肿瘤 药物疗法 奈达铂 顺铂 

分 类 号：R739.63[医药卫生—肿瘤]