局部晚期鼻咽癌不同诱导化疗方案联合同期放化疗的临床研究  

Clinical Evaluation of Induction Chemotherapy of NP or FP Plus Concurrent Chemoradiotherapy for Patients with Locally Advanced Nasopharyngeal Carcinoma

作　　者：张佩娟[1] 邹进军[1] 万海涛[1] 于兰[1] 张真[1] 韩淑红[1] 

机构地区：[1]青岛市肿瘤医院放疗科,266042

出　　处：《医学研究杂志》2014年第1期67-70,共4页Journal of Medical Research

基　　金：青岛市科技局基金资助项目[11234(6)nsh]

摘　　要：目的评价NP方案与FP方案诱导化疗+同期放化疗治疗局部晚期鼻咽癌的毒不良反应和疗效。方法 74例经病理学或细胞学证实的局部晚期鼻咽癌,按随机数字表法分为两组,NP方案化疗组和FP方案化疗组。NP方案化疗组,长春瑞滨和顺铂诱导化疗两个周期,然后调强放疗同期NP方案化疗。FP方案化疗组,氟尿嘧啶和顺铂诱导化疗,然后同期化疗。结果 NP组和FP组的近期疗效相似。两组的3年总生存率、无瘤生存率、无局部、区域复发生存率及无远处转移率差异无统计学意义,分别为84.2%和75.0%、71.1%和61.1%、89.5%和88.9%、81.6%和72.2%(P>0.05)。NP组患者的恶心呕吐、黏膜反应明显低于FP组(P<0.05),血液学毒性、皮肤炎及肝损伤两组比较,差异无统计学意义。结论 NP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与FP方案相似,毒性不良反应较低,患者可耐受,临床依从性好。Objective To compare the efficacy and side effect of induction chemotherapy with NP regimen followed concurrent che- moradiotherapy with FP regimen in treating locally advanced nasopharyngeal carcinoma （NPC）. Methods From January 2005 to Oc- tomber 2009, 74 patients with locally advanced nasopharyngeal carcinoma diagnosed pathologically were randomized into N P group（38 pa- tients） and FP group（36 patients）. Patients in both groups received induction chemotherapy and concurrent chemoradiotherapy. Induction chemotherapy and concurrent chemoratherapy regimen of NP group were consist of vinorelbine 25mg/m^2 on day 1 and day 8, DDP 25mg/ m^2 on day 1 to day 3 and FP group were consist of Fluorouracil 500 mg/m^2 onday 1 and day 5, DDP 25mg/m^2 on day 1 to day 3. After 2 cycles of induction chemotherapy, the patients received concurrent chemoradiotherapy. The chemotherapy was recycled every 3 weeks. Results The short - term efficacy of NP group was similar to that of FP group. The 3 - year overall survival rate, disease - free - survival rate, the locoregional relapse- free survival rates and distant metastasis- free survival rates in the NP group and FP group were 84.2% and 75.0% ,71.1% and 61.1% ,89.5% and 88.9% , 81.6% and 72.2% , respectively （P 〉 0.05 ）. The occurrence rates of cute mu- cositis and gastrointestinal toxicity were significantly higher in FP group than in NP group（ P 〈 0.05 ）. The hematologic toxicity, dermatitis and liver toxicity were similar in two groups. Conclusion The efficacy of NP regiment induction chemotherapy plus concurrent chemordi- otherapy for advanced NPC is similar to that of FP regiment. The toxicity of the former schedule is lower than that of the latter.

关 键 词：鼻咽肿瘤 诱导化学疗法 调强放射疗法 同步放化疗 不良反应 

分 类 号：R739.6[医药卫生—肿瘤]