甘氨双唑钠联合PLF方案同期放化疗治疗局部晚期鼻咽癌的临床对照研究  

Concurrent chemoradiotherapy with sodium glycididazole plus cisplatin and fluorouracil/leucovorin in treatment of local advanced nasopharyngeal carcinoma

作　　者：李铭仪[1] 刘锦全[1] 张秀萍[2] 陈冬平[1] 李健[1] 

机构地区：[1]广州医学院附属肿瘤医院放疗四区,广州510095 [2]广州医学院附属肿瘤医院放疗一区,广州510095

出　　处：《广东医学》2013年第1期132-136,共5页Guangdong Medical Journal

基　　金：广东省医学科研基金资助项目(编号:A2011289)

摘　　要：目的探讨甘氨双唑钠联合PLF方案(顺铂+5-氟脲嘧啶/醛氢叶酸)同期放化疗与单纯同期放化疗治疗局部晚期鼻咽癌的疗效及不良反应。方法 91例Ⅲ～Ⅳa期鼻咽癌患者,随机分成观察组(46例)和对照组(45例)。两组均采用常规放疗加PLF方案同期化疗。观察组同期配合甘氨双唑钠800 mg/m2放疗前1 h静脉滴注,每周3次。结果在放疗剂量至60 Gy时,观察组的鼻咽肿瘤及淋巴结转移灶的完全缓解率均明显高于对照组(93.5%vs 77.8%;89.1%vs 71.1%,P<0.05)。放疗结束后3个月,观察组鼻咽肿瘤及淋巴结转移灶完全缓解率均为97.8%,均分别高于对照组(84.4%及82.2%),差异有统计学意义(P<0.05)。观察组1、2、3年无瘤生存率分别为89.1%、65.5%、54.5%,对照组相应无瘤生存率分别为66.2%、48.2%、38.6%,差异有统计学意义(P=0.015)。两组患者的1、2、3年生存率则分别为97.8%、87.9%、70.3%及95.6%、75.0%、50.1%,差异有统计学意义(P=0.01)。急性不良反应及远期放射性损伤两组差异无统计学意义(P>0.05)。结论甘氨双唑钠提高局部晚期鼻咽癌疗效,不增加不良反应,值得临床推广应用。Objective To compare the efficacy between sodium glycididazole combining with cisplatin and flu- orouracil/leucovorin （PLF） in concurrent chemoradiotherapy （CCRT） and CCRT alone for local -advanced nasopharyn- geal carcinoma （NPC）. Methods Ninty - one patients with local - advanced （ Ⅲ-Ⅳa） were randomized into chemora- diotherapy with PLF schedule plus sodium glycididazole group （ therapy group, n = 46） and chemoradiotherapy with PLF schedule group （ control group, n = 45 ）. All the patients received radiotherapy and concurrent injection of cisplatin and fluorouracil/leucovorin. In therapy group, additional sodium glycididazole prior to the radiotherapy was given. Results At the radiotherapy dose of 60 Gy, the complete response rates of nasophayngeal tumor and local - regional lymph nodes in therapy group were significantly higher than those in control group （93.5% vs 77.8% and 89. 1% vs 71.1%, P 〈0. 05）. Three months after therapy, the corresponding complete response rates in therapy group were still significantly higher than those in control group （97.8% vs 84. 4% and 97.8% vs 82.2% , P 〈 O. 05 ）. The 1 - , 2 - , and 3 - year disease - free survival rates （DFS） in therapy group were 89. 1% , 65.5% and 54. 5% , respectively; and were 66. 2% , 48.2% and 38.6% , respectively, in control group, with significant differences between them （P =0. 015）. The 1 - , 2 - , and 3 - year overall survival rates （OS） in treatment group were 97.8% , 87.9% and 70. 3% , respectively; and were 95.6% , 75.0% and 50. 1% , respectively, in control group, with significant differences between the two group （P = 0. 01 ）. No significant difference in acute toxicities or long - term radioactive injury revealed between the two groups. Conclusion Sodium glycididazole plus cisplatin and fluorouracil/leucorovin can accelerate the tumor remission and improve the DFS and OS in patients with local advanced NPC without causing severe toxicity.

关 键 词：鼻咽癌 同期放化疗 放射增敏剂 甘氨双唑钠 临床对照研究 

分 类 号：R739.63[医药卫生—肿瘤]