多西他赛联合顺铂诱导化疗后三维适形调强放疗同步化疗对局部晚期鼻咽癌的疗效分析  

Efficacy of Docetaxel Combined with Cisplatin Induced Chemotherapy and Three-dimensional Conformal Radiotherapy and Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma

作　　者：朱锦贤[1] 刘园源 梁锦辉[1] 郭毅[1] 梁伟[1] 

机构地区：[1]广西壮族自治区梧州市红十字会医院,543002

出　　处：《实用癌症杂志》2016年第8期1357-1360,共4页The Practical Journal of Cancer

摘　　要：目的观察多西他赛联合顺铂诱导化疗后三维适形调强放疗同步化疗对局部晚期鼻咽癌的疗效。方法300例局部晚期鼻咽癌患者随机分为同步放化疗组(CCRT)和诱导化疗加同步放化疗组(ICCRT),ICCRT组先进行2个周期的多西他赛联合顺铂诱导化疗后再进行同步放化疗,CCRT组仅进行2个周期的多西他赛联合顺铂化疗,在此基础上,所有患者均进行三维适形调强放疗。比较两组患者近期疗效、局部控制率、无转移生存率、不良反应及相关功能。结果ICCRT组患者的近期疗效、局部控制率、无转移生存率、生理评分和生活质量评分均高于CCRT组患者,差异具有统计学意义(P<0.05)。ICCRT组和CCRT组均出现不同程度放射性食管炎、放射性肺炎、中性粒细胞减少、血红蛋白减少、恶心呕吐、口腔黏膜反应等,但差异无统计学意义(P>0.05)。结论多西他赛与顺铂的联合诱导化疗后同步放化疗治疗局部晚期鼻咽癌可明显提高临床疗效、局部控制率、无转移生存率,不良反应较轻,是治疗局部晚期鼻咽癌的可行方案。Objective To observe the effect of docetaxel and cisplatin induction chemotherapy before concurrent chemo- therapy and three-dimensional conformal adjusting radiotherapy for locally advanced nasopharyngeal carcinoma. Methods 300 patients with locally advanced nasopbaryngeal carcinoma patients were randomly divided into concurrent radiotherapy and chemo- therapy group （CCRT） and induction chemotherapy plus concurrent radiotherapy and chemotherapy （ICCRT） group. Patients in ICCRT group first received 2 cycles of doeetaxel combined with eisplatin induction chemotherapy followed by concurrent chemora- diotherapy, and patients in CCRT group received only 2 cycles of concurrent chemoradiotherapy. On this basis, all patients re- ceived three-dimensional conformal intensity modulated radiation therapy. The short-term efficacy, local control rate, non-metastat- ic survival rate, adverse reactions and correlation function were compared between the 2 groups. Results The short-term efficacy, local control rate, non-metastasis survival rate, physiological score and quality of life score in ICCRT group were higher than those of CCRT group, there had statistically significant difference （ P 〈 0.05 ）. Patients in ICCRT group and CCRT group both showed different degrees of radiation esophagitis and pneumonitis, neutrophil cells decreased, decreased hemoglobin, nausea, vomiting, oral q mucosa reaction and other adverse reactions, but there had no statistically significant difference （ P 〉 0.05 ）. Conclusion Do- cetaxel combined with eisplafin induction chemotherapy before concurrent chemotherapy and three-dimensional conformal adjus- ting radiotherapy for locally advanced nasopharyngeal carcinoma can significantly improve the curative effect, local control rate and metastasis free survival, with lighter adverse reactions, it is a feasible plan for locally advanced nasopharyngeal carcinoma.

关 键 词：多西他赛 顺铂 诱导化疗 三维适形调强放疗 同步化疗 鼻咽癌 

分 类 号：R739.63[医药卫生—肿瘤]