GP方案与PF方案诱导化疗序贯同步放疗治疗局部晚期鼻咽癌的效果比较  

Comparison of GP Regimen and PF Regimen in Induction Chemotherapy Followed by Synchronous Radiotherapy for Locally Advanced Nasopharyngeal Carcinoma

作　　者：魏照光 王长青[1] 成彦霖 梅宝富[3] WEI Zhao-guang;WANG Chang-qing;CHENG Yan-lin;MEI Bao-fu(Department of Oncology,Bao’an District People’s Hospital of Shenzhen,Shenzhen 518000,China;Department of Gastroenterology,Bao’an District People’s Hospital of Shenzhen,Shenzhen 518000,China;Department of Intervention,Bao’an District People’s Hospital of Shenzhen,Shenzhen 518000,China)

机构地区：[1]深圳市宝安区人民医院肿瘤科,广东深圳518000 [2]深圳市宝安区人民医院消化科,广东深圳518000 [3]深圳市宝安区人民医院介入科,广东深圳518000

出　　处：《实用临床医学（江西）》2020年第6期8-11,共4页Practical Clinical Medicine

基　　金：深圳市宝安区科技计划社会公益项目(医疗卫生)(2015021)。

摘　　要：目的比较GP(吉西他滨+顺铂)方案与PF(顺铂+氟尿嘧啶)方案诱导化疗序贯同步放疗治疗局部晚期鼻咽癌的临床疗效与安全性。方法将84例局部晚期鼻咽癌患者随机分为GP组和PF组,每组42例。PF组实施PF方案诱导化疗序贯同步放疗治疗,GP组实施GP方案诱导化疗序贯同步放疗治疗。比较2组的临床疗效、不良反应发生率、5年生存率(OS率)、局部无复发生存期率(LRFS率)及治疗前后T淋巴细胞亚群变化情况。结果GP组与PF组治疗总有效率比较差异无统计学意义(85.71%比83.33%,χ^2=0.091、P=0.763)。GP组与PF组的骨髓抑制、胃肠道反应、放射性口腔黏膜炎等不良反应发生率比较差异均无统计学意义(均P>0.05)。2组治疗后CD4+、CD4+/CD8+水平较治疗前均显著下降,但GP组下降程度明显低于PF组,差异均有统计学意义(均P<0.05)。GP组5年OS率以及LRFS率均显著高于PF组(均P<0.05)。结论GP方案与PF方案诱导化疗序贯同步放疗治疗局部晚期鼻咽癌的临床疗效与安全性相当,但GP方案对患者细胞免疫功能的影响较小,且预后更好。Objective To compare the clinical efficacy and safety of GP(gemcitabine+cisplatin)regimen and PF(cisplatin+fluorouracil)regimen in induction chemotherapy followed by synchronous radiotherapy for locally advanced nasopharyngeal carcinoma.Methods A total of 84 patients with locally advanced nasopharyngeal carcinoma were randomly assigned to receive induction chemotherapy followed by synchronous radiotherapy with either PF regimen(42 patients)or GP regimen(42 patients).Clinical efficacy,toxic and side effect,5-year overall survival(OS)rate,local relapse-free survival(LRFS)rate,and T lymphocyte subsets were compared between the two groups.Results There were no significant differences between PF group and GP group in the total effective rate(85.71%vs 83.33%,χ^2=0.091,P=0.763),as well as in the incidences of myelosuppression,gastrointestinal reaction,radioactive oral mucositis and other toxic and adverse reactions(P>0.05).The levels of CD4+and CD4+/CD8+significantly decreased in both groups after treatment,and the decrease in PF group was more obvious than that in GP group(P<0.05).Both 5-year OS rate and LRFS rate in PF group were higher than those in GP group(P<0.05).Conclusion The clinical efficacy and safety of GP regimen and PF regimen are comparable in the treatment of local advanced nasopharyngeal carcinoma.However,GP regimen exerts less effect on cellular immune function and has a better prognosis than PF regimen.

关 键 词：局部晚期鼻咽癌 吉西他滨 顺铂 氟尿嘧啶 化疗序贯同步放疗 临床效果 安全性 

分 类 号：R739.62[医药卫生—肿瘤]