长春瑞滨加顺铂和多西他赛加顺铂方案诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的随机对照研究  

Evaluation of induction chemotherapy with vinorelbine plus cisplatin （NP） or docetaxel plus cisplatin （TP） combined with concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma

作　　者：韩淑红[1] 于兰[1] 张真[1] 张佩娟[1] 宋海平[1] 郭成业[1] 

机构地区：[1]青岛市肿瘤医院放疗科,266042

出　　处：《中华肿瘤杂志》2013年第8期623-626,共4页Chinese Journal of Oncology

基　　金：青岛市公共领域科技支撑计划项目[11-2-34（6）-nsh]

摘　　要：目的 比较长春瑞滨＋顺铂（NP）和多西他赛＋顺铂（TP）方案诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的疗效和不良反应。方法146例局部晚期鼻咽癌患者随机分为NP方案化疗组（NP组）和TP方案化疗组（TP组），其中NP组76例，TP组70例。两组患者均行2个周期的诱导化疗，诱导化疗结束后3周开始同期放化疗。治疗结束后比较两组患者的疗效、生存率和不良反应。结果NP组和TP组患者的有效率均为100％。NP组和TP组患者的3年生存率分别为84．2％（64／76）和82．9％（58／70），无瘤生存率分别为71．1％（54／76）和74．3％（52／70），无局部、区域复发生存率分别为89．5％（68／76）和91．4％（64／70），无远处转移率分别为81．6％（62／76）和77．1％（54／70），差异均无统计学意义（均P〉0．05）。NP组患者的血液学毒性如白细胞减少、血红蛋白减少和黏膜反应发生率明显低于TP组（均P〈0．05）。结论NP方案和TP方案诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的临床疗效相似，不良反应较低，患者可耐受，临床依从性好。Objective To compare the efficacy and side effects of induction chemotherapy with vinorelbine plus cisplatin （NP） or docetaxel plus cisplatin （TP） combined with concurrent chemoradiotherapy in treating locally advanced nasopharyngeal carcinoma （NPC）. Methods From January 2005 to December 2009, 146 patients with locally advanced nasopharyngeal carcinoma treated in our department were randomized into NP group （76 patients） or TP group （70 patients）. Both groups received two cycles of induction chemotherapy and concurrent chemoradiotherapy. After three weeks of induction chemotherapy, the patients received concurrent chemoradiotherapy. The chemotherapy was recycled every three weeks. Two groups were treated with intensity-modulated radiation therapy. Results The short-term efficacy of NP group was similar to that of TP group. The 3-year overall survival rates, disease-free-survival rates, locoregional relapse-free survival rates and distant metastasis-free survival rates in the NP and TP groups were 84. 2% and 82. 9% , 71. 1% and 74. 3%, 89. 5% and 91.4%, 81.6% and 77. 1%, respectively （ P 〉 0.05 ）. The occurrence rates of leucopenia, anemia and acute mucositis were significantly higher in the TP group than those in the NP group （P 〈 0.05 ）. The gastrointestinal toxicity, dermatitis and liver toxicity were similar in the two groups. Condusions The efficacy of NP regimen induction chemotherapy plus concurrent ehemordiotherapy for advanced NPC is similar to that of TP regimen. The toxicity of the NP regimen is lower than that of NP regimen, tolerable, and with a good compliance.

关 键 词：鼻咽肿瘤 药物疗法 放射疗法 预后 长春瑞滨 顺铂 多西他赛 

分 类 号：R739.63[医药卫生—肿瘤]