甘氨双唑钠对局部晚期喉癌放疗增敏作用的远期效果  

Long-Term Radiation-Enhancing Effect of Sodium Glycididazole in Regionally Advanced Laryngeal Cancer

作　　者：曾越灿[1,2] 迟峰[1] 吴荣[1] 邢锐[1] 陈佳佳[1] 吴丽娜[1] 王思亮[1] 陈欢欢[1] 蔡炜嵩[1] 肖玉平[2] 

机构地区：[1]中国医科大学附属盛京医院肿瘤科,沈阳110022 [2]中国医科大学附属第一医院第四肿瘤研究所,沈阳110001

出　　处：《临床误诊误治》2015年第3期97-100,共4页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金资助项目(81201803);辽宁省科技厅科学计划项目(2011404013-3;2013225079);教育部高等学校博士学科点专项科研基金(20122104110028)

摘　　要：目的观察甘氨双唑钠对接受化疗的局部晚期喉癌放疗增敏作用的远期效果。方法选择局部晚期喉癌60例,分为甘氨双唑钠加放疗组(观察组)30例和单纯放疗组(对照组)30例。观察组采用甘氨双唑钠700 mg/m2溶于0.9%氯化钠注射液100 ml中,20 min内滴完,每周3次,共21次,药物滴完后30 min内进行常规放疗;对照组采用安慰剂加0.9%氯化钠注射液,方法同观察组。观察终点为无进展生存期、总生存期和远期毒性及不良反应。结果观察组与对照组分别有27例、24例完成治疗,观察组和对照组中位无进展生存期分别为1.9、1.6年,差异有统计学意义(P=0.026);观察组和对照组中位总生存期分别为2.7、2.2年,差异无统计学意义(P=0.727)。两组均未出现远期严重毒性及不良反应。多因素分析提示N分期及肿瘤位置是无进展生存的预后影响因素,风险比(HR)分别为1.86、3.33;T分期和N分期是总生存期的预后影响因素,HR分别为3.08、1.95。结论甘氨双唑钠对局部晚期喉癌有明显的放疗增敏作用,可以延长患者的无进展生存期,且患者耐受性良好。Objective To evaluate the long-term radiation-enhancing effect of sodium glycididazole as a hypoxic radi-osensitizer on the radiotherapy for regionally advanced laryngeal cancer previously treated with chemotherapy. Methods A to-tal of 60 patients with locoregionally advanced laryngeal cancer were divided into the observation group （sodium glycididazole plus radiotherapy, 30 patients） and the control group （radiotherapy alone, 30 patients）. The observation group received sodi-um glycididazole at a dose of 700 mg/ m2 in solution of 100 ml saline intravenous infusion（0. 9% ） 30 minutes before radiother-apy, and three times a week （finished in 20 min every time）, for a total of 21 times. The control group received placebo in saline solution （0. 9% ）. Surrogate end-points of efficacy were progression-free survival, overall survival and late toxic and ad-verse effects. Results In this study, 27 cases completed the course of treatment in the observation group and 24 cases com-pleted the course of treatment in the control group, and the median progression-free survival time was 1. 9 years in the observa-tion group and 1. 6 years in the control group （P = 0. 026）. The median overall survival time was 2. 7 years in the observation group and was 2. 2 years in the control group （P = 0. 727）. There was no significant difference between the two groups in long-term adverse effects. Multivariate analysis showed that N stage and tumor site were independent prognostic indicators for progression-free survival, with a hazard ratio of 1. 86 and 3. 33. T stage and N stage were independent prognostic indicators for overall survival, with a hazard ratio of 3. 08 and 1. 95, respectively. Conclusion Sodium glycididazole is an effective radia-tion-enhancing agent that can prolong the median progression-free survival time and is well tolerated in patients with regionally advanced laryngeal cancer.

关 键 词：喉肿瘤 放疗 甘氨双唑钠 辐射增敏药 

分 类 号：R739.65[医药卫生—肿瘤]