甲地孕酮对局部晚期鼻咽癌放化疗耐受性的临床研究  

Clinical study of megestrol on tolerance of radiotherapy and chemotherapy in locally advanced nasopharyngeal carcinoma

作　　者：龙斌[1] 刘利民[1] 杨新辉[1] 曾鸣 施晓焱 龙君 李树梁 周光华[1] LONG Bin;LIU Li-min;YANG Xin-hui;ZENG Ming;Sill Xiao-yan;LONG Jun;ZHOU Guang-hua(Department of Oncology;Department of Special Clinic,the 163~ Hospital of People＇s IJberation Army,the Second Affiliated Hospital of Hunan Normal University,Changsha 410003,Hunan,CHINA)

机构地区：[1]中国人民解放军一六三医院湖南师范大学第二附属医院肿瘤科,湖南长沙410003 [2]中国人民解放军一六三医院湖南师范大学第二附属医院特诊科,湖南长沙410003

出　　处：《海南医学》2018年第16期2244-2248,共5页Hainan Medical Journal

摘　　要：目的研究甲地孕酮对局部晚期鼻咽癌放化疗耐受性的影响。方法回顾性分析解放军第一六三医院肿瘤科2014年10月至2017年2月收治的197例鼻咽癌患者的临床资料,根据治疗方案分为对照组(n=99)和观察组(n=98),对照组采用放化疗治疗,观察组在对照组基础上加用甲地孕酮治疗,比较两组患者的不良反应、生活质量、耐受性和临床疗效。结果骨髓抑制研究组始终较对照组少,在第2~5周期间比较差异均无统计学意义(P>0.05),但在第6~7周期间研究组分别为6.1%、7.1%,明显少于对照组的15.2%、18.2%,差异均有统计学意义(P<0.05);恶心呕吐观察组始终较对照组少,在第2~6周期间比较差异均无统计学意义(P>0.05),而在第7周观察组为10.2%,明显少于对照组的21.2%,差异有统计学意义(P<0.05);两组患者治疗期间的口干、口腔黏膜、颈部皮肤的放射损伤反应比较差异均无统计学意义(P>0.05),但乏力反应研究组为53.1%,明显少于对照组的71.7%,差异有统计学意义(P<0.05);KPS评分观察组始终较对照组好,在第1~3周期间比较差异均无统计学意义(P>0.05),但在第4~7周期间差异均有统计学意义(P<0.05);体质量变化研究组始终较对照组多,在第1周比较差异无统计学意义(P>0.05),而在第2~7周比较差异均有统计学意义(P<0.05或0.01);延长住院时间观察组为4.1%,明显少于对照组的21.2%,差异有统计学意义(P<0.05);观察组患者的近期治疗有效率为88.8%,对照组为86.9%,差异无统计学意义(P>0.05)。结论甲地孕酮能增加鼻咽癌放化疗的耐受性,且其他不良反应轻微。Objective To study the effect of megestrol on tolerance of radiotherapy and chemotherapy in locally advanced nasopharyngeal carcinoma. Methods The clinical data of 197 patients with nasopharyngeal carcinoma admitted to the Department of Oncology in the 163 thHospital of People＇s Liberation Army from October 2014 to February2017 were analyzed retrospectively. The patients were divided into control group（n=99） and observation group（n=98）according to the therapeutic regimen. The control group was treated with radiotherapy and chemotherapy. The observation group was treated with megestrol on the basis of the control group. Adverse reactions, quality of life, tolerance and clinical efficacy were compared between the two groups. Results The bone marrow suppression in the observation group was always less than that in the control group, with no statistically significant difference in 2 ndto 5 thweeks（P0.05）. However, the adverse reactions rate in the 6 thto 7 thweeks of the observation group was 6.1%, 7.1%, respectively,which was significantly less than 15.2%,18.2% of control group（P0.05）. The nausea and vomiting in observation group was always less than the control group, with no statistically significant difference in 2 nd^6 thweeks（P0.05）, but the incidence in the 7 thweek of observation group was 10.2%, which was significantly less than 21.2% of the control group（P0.05）. There were no statistically significant differences in radiation injury response between the two groups（stomach,oral mucous membrane and neck skin）（P0.05）. However, the fatigue response in observation group was 53.1%, which was significantly less than 71.7% in control group（P0.05）. The KPS score in observation group was always better than that in the control group, with no statistically significant difference in 1 stto 3 rdweeks（P0.05）. However, the differences were statistically significant between 4 thto 7 thweeks（P0.05）. The weight change in observation group was always more than the control group, wi

关 键 词：甲地孕酮 鼻咽癌 不良反应 生活质量 耐受性 疗效 

分 类 号：R739.63[医药卫生—肿瘤]