诱导化疗加同步放化疗治疗局部晚期鼻咽癌的疗效观察  

Clinical efficacy of induction chemotherapy plus concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma

作　　者：谢源福[1] 林坤花[1] 卓延红[1] 李艺江[1] 陈伟霖[1] 陈贵平[1] 陈丽民[1] 江少娜[1] 黄建丽[1] 

机构地区：[1]福建医科大学附属漳州市医院肿瘤放射治疗科,漳州363000

出　　处：《中国肿瘤临床与康复》2014年第2期198-201,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的对比分析诱导化疗加同步放化疗治疗局部晚期鼻咽癌的临床疗效。方法 148例患者随机分为治疗组与对照组,各74例。治疗组患者采用奈达铂(NDP)联合替加氟(FT-207)诱导化疗加放射治疗同步奈达铂化疗方案,对照组患者采用顺铂(DDP)联合氟尿嘧啶(5-Fu)诱导化疗加放射治疗同步顺铂化疗方案,观察两组患者的临床疗效、生存率和不良反应发生情况。结果治疗组患者鼻咽部肿瘤完全消退率为95.9%,有效率为98.6%;颈部淋巴结完全消退率为94.6%,有效率为98.6%。对照组患者鼻咽部肿瘤完全消退率为93.2%,有效率为98.64%;颈部淋巴结完全消退率为89.2%,有效率为97.3%,两组患者近期疗效差异无统计学意义(P>0.05);诱导化疗中,治疗组患者恶心呕吐、白细胞减少发生率低于对照组,差异有统计学意义(P<0.05)。同期化疗中,治疗组患者血小板减少发生率低于对照组,差异有统计学意义(P<0.05);两组患者总生存率、无复发生存率和无转移生存率比较,差异均无统计学意义(P>0.05)。结论奈达铂和替加氟诱导化疗联合同期放射治疗与顺铂和氟尿嘧啶诱导化疗联合同期化疗疗效相当,而且奈达铂和替加氟方案消化道不良反应、白细胞减少情况优于顺铂和氟尿嘧啶方案,值得推广,远期疗效有待观察。Objective To evaluate the clinical efficacy of locally advanced nasopharyngeal carcino- ma treated with nedaplatin （NDP） combined tegafur （FT-207） plus radiotherapy（ treatment group） and cis- platin （DDP） combined 5-fluorouracil （5-Fu） plus radiotherapy （ control groups ） respectively. Methods 148 patients with locally advanced nasopharyngeal carcinoma were randomly divided into treatment group and control group,74 patients in each group. The treatment group received NDP combined FT-207 , the con- trol group DDP plus 5-Fu. The clinical effects, survival rates and incidence of adverse reaction were ana- lyzed. Results The complete response rate and the efficient rate of nasopharyngeal carcinoma was 95.9% and 98.6% and of cervical lymph node was 94. 6% and 98.6% in treatment group. By contrast,the com- plete response rate and the efficient rate of nasopharyngeal carcinoma was 93.2% and 98. 6% , and of cervi- cal lymph node 89.2% and 97.3% in control group respectively. Results showed no significant difference in the complete response rate and the efficient rate of both nasopharyngeal carcinoma and cervical lymph node with two groups （ P 〉 0.05 ）. However ,for the incidence of adverse reactions ,the differences in nausea, vomiting and hypoieueocytosis between the two groups were significant （ P 〈 0. 05 ）, and the oceurrent rate of treatment group was lower. In concomitant chemotherapy, the oecun＇ent rate of tbromboeytopenia of treatment group was lower than control group, the results of two groups were also significant （ P 〈 0. 05 ）. There were no differences in overall survival, recurrence-free survival and distance-disease-free survival beteen two groups. Conclusions NDP combined FT-207 has the same efficacy as PF scheme in the induction chemotherapy plus concurrent radiotherapy treatment of locally advanced nasopharyngeal carcinoma, but NDP combined FT-207 was better than PF scheme in gastrointestinal side effects and hypoleucocytosis and worthy of being widely applied

关 键 词：鼻咽癌 诱导化疗 同步放化疗 

分 类 号：R739.63[医药卫生—肿瘤]