多西他赛联合奈达铂诱导化疗及奈达铂单药同期放化疗治疗晚期鼻咽癌的临床观察  

Clinical study of inductive chemotherapy with docetaxel plus nedaplatin followed by concurrent nedaplatin with radiotherapy for advanced nasopharyngeal carcinoma

作　　者：罗金红[1] 林昀[1] 周俊[1] 李琦[1] 林根来[2] 高勇[1] 

机构地区：[1]同济大学附属东方医院肿瘤内科,上海200120 [2]复旦大学附属中山医院放疗科,上海200032

出　　处：《肿瘤》2011年第6期532-537,共6页Tumor

基　　金：上海市浦东新区卫生系统中青年业务骨干培养基金

摘　　要：目的:比较多西他赛联合奈达铂(DN)与顺铂联合氟尿嘧啶(PF)诱导化疗及奈达铂单药同期放化疗治疗局部晚期鼻咽癌的急性不良反应、依从性及近期疗效。方法:经组织病理学确诊的局部晚期鼻咽癌患者64例,随机分为DN组和PF组。DN组和PF组患者分别接受DN或PF方案诱导化疗2个周期,随后行放疗以及2个周期的奈达铂单药同期化疗。观察两组患者治疗期间的不良反应和耐受性,以及近期疗效。结果:DN组的平均化疗周期数比PF组多(分别为3.63和3.06个周期,P=0.038)。DN组和PF组的3～4度中性粒细胞减少的发生率分别为37.50%和6.25%,差异有统计学意义(P=0.0025)。DN组患者的恶心和呕吐的发生率(6.25%)明显低于PF组(46.88%,P=0.0086)。两组的近期疗效及1年总生存率差异均无统计学意义(P>0.05)。结论:DN诱导化疗方案是治疗局部晚期鼻咽癌的有效方案,近期疗效与PF方案相似,在减少恶心和呕吐等胃肠反应方面,较PF方案显示出明显的优势。Objective：To compare the acute adverse reaction,treatment compliance and short-term response between inductive chemotherapy with DN regimen（docetaxel plus nedaplatin） and PF regimen（cisplatin plus 5-fluorouracil） followed by concurrent nedaplatin with radiotherapy in patients with advanced nasopharyngeal carcinoma（NPC）.Methods：A total of 64 patients with advanced regional nasopharyngeal carcinoma confirmed by histopathological diagnosis were randomized into two groups：DN group（n=32） and PF group（n=32）.The patients in the two groups received two cycles of inductive chemotherapy with DN regimen or PF regimen,and then followed by radiotherapy concurrent with two cycles of nedaplatin chemotherapy.The adverse reaction,therapeutic tolerance and short-term response were evaluated.Results：More chemotherapy courses were finished in DN group than in PF group（3.63 vs 3.06,P=0.038）.More grade 3-4 neutropenia occurred in DN group than in PF group（37.50% vs 6.25%,P=0.002 5）,whereas more patients in the PF group suffered from nausea and vomiting（46.88% vs 6.25%,P=0.008 6）.than in the DN group.There was no significant difference in short-term efficacy and one-year survival rate between the two groups（P〉0.05）.Conclusion：DN regimen is effective and well-tolerated in patients with advanced nasopharyngeal carcinoma,and the response rate between DN regimen and PF regimen is similar.DN regimen also shows a significant superiority in reducing nausea and vomiting.

关 键 词：鼻咽肿瘤 诱导化疗 同期放化疗 多西他赛 奈达铂 

分 类 号：R734.2[医药卫生—肿瘤]