TP与DF化疗方案治疗鼻咽癌肝、肺转移的疗效比较

Comparison of the Effect of Paclitaxel and 5-Fluorouracil Combined with Cisplatin in the Treatment of Liver and Lung Metastasis Tumors from Advanced Nasoplaryngeal Carcinoma

目的探讨紫杉醇(paclitaxel)+顺铂(cisplatin,DDP;TP方案)与5-氟脲嘧啶(5-Fluorouracil,5-Fu)+DDP(DF方案)治疗晚期鼻咽癌肝、肺转移的客观疗效及毒副作用。方法对56例共211个疗程TP(30例)或DF(26例)方案化疗的鼻咽癌肝、肺转移病例的临床疗效及其副作用进行了回顾性分析比较。同一化疗方案的病例列为一组,即分为TP组(30例)和DF组(26例)。两组均以3周为1个疗程,至少接受2个疗程化疗。分别总结两组的有效率,中位生存期和白细胞数、血小板计数,恶心、呕吐、腹泻、口腔炎、脱发等副反应的发生构成比,并进行统计、分析。结果TP方案组的总有效率为73.33%,明显高于DF方案组的46.15%(P<0.05);TP组和DF组中位生存期分别为11.8个月和9.8个月,但经Logrank检验无明显差异性(P>0.05)。治疗毒副反应,TP组以脱发(100%)、白血球下降(83.33%)和血小板下降(50%)为主。而DF组则以恶心、呕吐(76.92%)、腹泻(73.07%)、口腔炎(46.15%)等消化道反应明显。结论TP方案治疗晚期鼻咽癌肝、肺转移疗效明显优于DF方案,中位生存期TP组也高于DF组。毒副反应各自有别,但均以Ⅰ、Ⅱ度反应明显,患者均可接受。

Objective To explore the effect and toxic side-effect of paclitaxel plus cisplatin（TP regiment） and 5-Fluoreracil plus cisplatin combination chemotherape in the treatment of liver and lung metastasis tumors from advanced nasoplaryngeal cancer. Methods 56 patients who received 2ll course treatment with TP（30 cases） or DF （26 eases） regiment were retrospectively analyzed and compared the toxic side-effect. The patients were divided two groups. The first group with 30 patients was treated with TP regiment. The second group with 26 patients was treated with DF regiment. Each treatment cycle was three weeks. Each patient received no less than 2 courses of treatment. It was anlayzed the effective median survival time and the proportion of main side-effect which was determined by the leucocyte quantity, platelet quantity, nausea, vomiting, diarrhoea, mucositis and alopecia. Results It shows the effective rate of TP regiment was 73.33%, which was apparently higher than 46.15%（P〈0.05） in DF regiment group. The median survival time was 11.8 and 9.8 months in TP and DF regiment group, respectively. But the difference was not significant when analyzed by logrank study （P〉0.05）. The main toxic side-effects were alopecia （100%）, leucocyte reduction （83.33%） and platelet reduction （50%） in TP regiment group. The obvious side-effects in DF regiment were nausea and vomiting （76.92%）, diarrhea （73.07%） and mucositis （46.15%）. Conclusion The treatment effect and median survival in TP regiment group were apparently higher than those in DF regiment group. The toxic side-effects were tolerable and mild.