多西他赛联合奈达铂在局部晚期鼻咽癌中的近远期疗效、安全性及预后分析  

Analysis of clinical efficacy, safety and prognosis of docetaxel combined with nedaplatin in local advanced nasopharyngeal carcinoma

作　　者：刘同欣[1] 孙权权[1] 陈晶[1] 李斌[1] 秦卫丰[1] 王方正[1] 傅真富[1] 胡福军[1] LIU Tongxin;SUN Quanquan;CHEN Jing;LI Bin;QIN Weifeng;WANG Fangzheng;FU Zhenfu;HU Fujun(Department of Radiation Oncology,Zhejiang Cancer Hospital,Zhejiang Province,Hangzhou,310022,China)

机构地区：[1]浙江省肿瘤医院放疗科

出　　处：《中国医药导报》2019年第23期150-155,共6页China Medical Herald

基　　金：国家自然科学基金资助项目(81502647、81502646);浙江省医药卫生科技计划项目(2016KYB042、2018KY298)

摘　　要：目的探讨多西他赛联合奈达铂(TP)及氟尿嘧啶联合顺铂(PF)的诱导化疗方案在局部晚期鼻咽癌的有效性及安全性。方法回顾性分析2012年1月~2014年5月在浙江省肿瘤医院接受TP或PF诱导化疗方案的271例患者,8例失访,最终263例纳入分析,其中PF组92例,TP组171例,比较两组患者的疗效、安全性及预后。结果两组5年总生存率(OS)、无进展生存率(PFS)、局部无复发生存率(LRFS)、无远处转移生存率(DMFS)比较,差异均无统计学意义(均P>0.05)。进一步多因素分析显示,N分期是5年OS、PFS和DMFS的独立预后因素(P<0.05)。不良反应分析显示,TP组更容易发生3~4级的白细胞、中性粒细胞和血小板减少,而PF组更容易发生3~4级的恶心和呕吐,差异有统计学意义(P<0.05)。两组其余不良反应比较,差异无统计学意义(P>0.05)。结论TP和PF的诱导化疗治疗局部晚期鼻咽癌效果相当,不良反应均可耐受,可用于治疗局部晚期鼻咽癌。Objective To evaluate the efficacy and safety of Docetaxel combined with Nedaplatin(TP)and Fluorouracil combined with Cisplatin(PF)in the treatment of locally advanced nasopharyngeal carcinoma.Methods Retrospective analysis of 271 patients who received TP or PF induction chemotherapy in Zhejiang Cancer Hospital from January 2012 to May 2014,8 cases were lost to follow-up,and 263 cases were finally included in the analysis,including 92 cases in PF group and 171 cases in TP group.Efficacy,safety and prognosis of the two groups were compared.Results The 5-year overall survival rate(OS),progression-free survival rate(PFS),local recurrence free survival rate(LRFS),and distant metastasis free survival rate(DMFS)were compared,the differences were not statisticdly significant between the two groups(all P>0.05).Further multivariate analysis showed that N staging was an independent prognostic factor for 5-year OS,PFS and DMFS(P<0.05).Adverse reaction analysis showed that grade 3-4 leukopenia,neutrophilia and thrombocytopenia were more likely to occur in the TP group,while grade 3-4 nausea and vomiting were more likely to occur in the PF group,with statistically significant differences(P<0.05).There were no statistically significant differences in other adverse reactions between the two groups(P>0.05).Conclusion The efficacy of TP and PF induction chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma is similar,and the adverse reactions are tolerable,which can be used in the treatment of locally advanced nasopharyngeal carcinoma.

关 键 词：诱导化疗 奈达铂 多西他赛 鼻咽癌 

分 类 号：R739.6[医药卫生—肿瘤]