多西他赛同步放、化疗治疗局部晚期鼻咽癌的疗效观察

Concurrent Radiotherapy and Chemotherapy with Docetaxel For Local-advanced Nasopharyngeal Carcinoma

目的:观察多西他赛同步放、化疗治疗晚期鼻咽癌的临床疗效和毒副作用,方法:132例局部晚期鼻咽癌患者随机分为两组,一组66例为多西他赛同步化疗+放疗(治疗组),另一组66例为PF(DDP+5Fu)方案同步化疗+放疗(对照组)。结果:在放疗肿瘤量DT50Gy时治疗组鼻咽病灶消退率、颈部转移灶消退率分别为65.2%、69.7%,对照组分别为59.1%、63.6%(P>0.05)。全程放疗结束后3个月治疗组鼻咽病灶消退率、颈部转移灶消退率分别为95.5%、93.9%,对照组分别为87.8%、86.4%(P>0.05)。中位随访35个月(11个月～60个月),3a总生存率、中位生存时间治疗组为81.9%、53个月,对照组为75.3%、52个月(P>0.05),3a无进展生存率及中位无进展生存时间治疗组为70.2%、40月,对照组为64.0%、39个月(P>0.05)。3a局部控制率、中位无复发生存期分别是76.5%、52个月和70.7%、45个月(P>0.05)。对照组的毒副作用如恶心、呕吐、骨髓抑制均较治疗组明显,差异有显著性(P<0.05)。结论:多西他赛同步放化疗与PF方案同步放化疗治疗晚期鼻咽癌,生存率及局部控制率相近,前者毒副作用较轻。

Objective To evaluate the efficacy and side-effects of concurrent radiotherapy and chemotherapy with Docetaxel for local-advanced nasopharyngeal carcinoma（NPC）. Methods 132 patients with local-advanced NPC were randomized into two groups：66 cases in treatment group were treated concurrent radiotherapy and chemotherapy（CCRT） with Docetaxel whereas 66 cases in control group received CCRT with PF（cisplatin and fluorouracil）. Results The dose of radiation was 50 Gray （Gy） the nasopharyngeal lesion remission rate and cervical metastasis remission rate were 65. 2% ,69.7% in treatment group and 59.1% ,63.6% in control group（P〉0.05）. 3 months after radiotherapy the nasopharyngeal lesion remission rate and cervical metastasis remission rate were 95.5 % ,98.5 % in treatment group and 87.8% ,86.4 %in control group（P〉0.05）. With a median follow up of 35 months（rang from 11-60 months） ,the overall survival rate at 3-year was 81. 9%, the median survival time was 53 months in treatment group, whereas in control group they were 75.3%, 52 months respectively（P〉0.05）. The 3-year progress-free survival rate and median progressfree survival time was 70.2% ,40 months in treatment group and 64.0% ,39months in control group（P〉0.05）. The 3 year locoregional control rate and median relapse-free survival time were 75.6 %, 52 months in treatment group and 70. 7 %,45 months in control group（P〉0.05）. Side-effects such as nausae, vomit and myelosuppression were more severe in control group than that in treatment group （P〈0.05）. Conclusion Concurrent radiotherapy and chemotherapy with Docetaxel is a effect regimen for local advanced nasophar yngeal carcinoma comparing with PF regimen, with similar survival rate and locoregional control rate but relatively lower side-effects.