中药防治鼻咽癌综合治疗中口咽急性毒性的临床研究  

Clinical Study in Prophylactic Use of Chinese Medicine to Prevent Chemoradiotherapy Induced Mucositis in Nasopharyngeal Carcinoma

作　　者：黄国贤[1] 赵充[2] 韩非[2] 张蓓[1] 丘惠娟[1] 徐伯平[1] 陈徐贤[1] 胡丕丽[1] 

机构地区：[1]中山大学附属肿瘤防治中心中医科,广东广州510060 [2]中山大学附属肿瘤防治中心放疗科,广东广州510060

出　　处：《癌症》2003年第10期1084-1087,共4页Chinese Journal of Cancer

摘　　要：背景与目的:口咽炎是鼻咽癌放射治疗中最常见的非血液学急性毒性,在肿瘤晚期患者的放化综合治疗中尤为严重,并可能影响治疗结果。本研究拟探讨中药配合鼻咽癌放化综合治疗,以防治口咽急性毒性的疗效。方法:选择101例临床分期为Ⅲ～Ⅳa期的鼻咽癌患者随机分为实验组(配合中药)52例,对照组(使用朵贝氏液)49例。两组患者鼻咽平均放疗剂量为:实验组(70.31±1.21)Gy,对照组(70.78±1.95)Gy。化疗采用同期放化疗方法:DDP30mg/cm2,每周1次,放疗第1至6周,共6次。从放疗开始至结束,实验组服中药每日一剂,分5至8次含服;对照组每日用朵贝氏液含漱5～8次。观察指标:口咽和血液急性毒性分级、放疗疗程总时间以及近期疗效。结果:(1)口咽毒性:实验组和对照组均无0级口咽急性毒性,Ⅰ～Ⅳ级急性毒性分别为Ⅰ级29例(55.77%)和2例(4.08%),Ⅱ级18例(34.62%)和17例(30.69%),Ⅲ级5例(9.62%)和22例(44.89%),Ⅳ级0例(0%)和8例(16.33%),两组比较有显著性差异(P=0.000);(2)血液学急性毒性:两组病例均无Ⅳ级血液学毒性发生,其中两组白细胞急性毒性比较(Z=-0.604,P=0.546),两组中性粒细胞急性毒性比较(Z=-0.226,P=0.821),两组血小板急性毒性比较(Z=-0.099,P=0.922),治疗过程中两组患者血液学急性毒性相似(P>0.05);(3)BACKGROUND &OBJECTIVE:Oropharyngeal mucositis is the most common acute non hematology toxicity in nasopharyngeal carcinoma (NPC) treated with radiotherapy, especially in the concomitant chemoradio therapy of local advanced NPC patients. This study was designed to observe the effect of traditional Chinese medicine against acute oropharyngeal mucositis from chemoradiotherapy in patients with local advanced NPC. METHODS: A total of 101 patients in stage Ⅲ-Ⅳa (Fuzhou 1992) were enrolled into this prospective randomized clinical trial. The cases were divided into treatment group (52 cases) and control group (49 cases). The median doses were 70.31±1.21 Gy for the treatment group and 70.78±1.95 Gy for the control group, respectively. Chemotherapy was concomitant with radiotherapy [single agent cisplatin (DDP,30 mg/m2) 6 times from first to sixth week of radiotherapy duration]. The patients of treatment group took 5-8 times of Chinese medicine daily and those of control group took 5-8 times of Dobells solution daily.The observation indices included the degree of oropharyngeal and hematological toxicity, radiotherapy duration, and curative effect. RESULTS:(1)Oropharyngeal toxicity: there was no 0 degree oropharyngeal toxicity in both groups, Ⅰdegree toxicity in 29 cases (55.77%) and 2 cases (4.08%), Ⅱdegree toxicity in 18 cases (34.62%) and 17 cases (30.69%), Ⅲdegree toxicity in 5 cases (9.62%) and 22 cases (44.89%), Ⅳdegree toxicity in 0 case (0%) and 8 cases (16.33%); there was statistical significance of difference between the two groups (P=0.000). (2)Hematological toxicity: there was no Ⅳdegree hematological toxicity in both groups. WBC toxicity (Z=-0.604,P=0.546), neutrophilic granulocyte toxicity (Z=-0.226,P=0.821), and platelet toxicity (Z=-0.099,P=0.922) were compared; there was no statistic significance of difference (P >0.05); (3)Radiotherapy duration: The radiotherapy duration of two groups were 49.79±1.83 days and 51.00±4.46 days; there was no statistic significance of difference (P=0.08

关 键 词：中医药治疗 鼻咽癌 口咽炎 急性毒性 放射治疗 

分 类 号：R739.63[医药卫生—肿瘤]