阿米福汀对头颈部鳞癌放、化疗疗效和血液毒性的临床观察

Efficacy of Amifostine on Patients with Head and Neck Squamous Cell Carcinomas Undergoing Radiation Therapy and Chemotherapy and Clinical Observation on Its Hematologic Toxicity

目的:观察阿米福汀对超分割放疗联合顺铂、多西紫杉醇和5-氟尿嘧啶治疗头颈部鳞癌的近期疗效和血液毒性。方法:37例头颈部鳞癌患者,随机分为2组,对照组19例予以超分割放疗联合顺铂、多西紫杉醇和5-氟尿嘧啶方案,保护组18例在对照组基础上加用阿米福汀,观察2组近期疗效、急慢性放射损伤及血液毒性结果。结果:保护组与对照组近期疗效有效率分别为44%、39%(P=0·683),前者急慢性放射损伤明显更轻,白细胞最低值更高,外周血毒性Ⅱ级以上毒性发生率更低。结论:阿米福汀对超分割放疗联合化疗治疗头颈部鳞癌的近期疗效无明显影响,但能减轻放疗引起的局部急慢性放射损伤,并对骨髓有一定保护作用。

OBJECTIVE ： To observe the near- future efficacy of amifostine on patients with head and neck squamous cell carcinomas undergoing hyper- fractionated radiation therapy combined with chemotherapy of cisplatin, docetaxel and 5- fluorouracil（5- FU） and to evaluate its hematologic toxicity. METHODS： 37 patients with head and neck squamous cell carcinomas were randomized to two groups： control group undergoing hyperfractionated radiation in combination with the chemotherapy of cisplatin, docetaxel and 5- FU regimen, and protection group undergoing the additional amifostine injection on the basis of same regimen with that in control group. The near-future efficacy, acute and chronic radiation damage as well as hematologic toxicity were observed in both groups. RESULTS： The effective rates in protection and control group were 44% and 39% （P = 0.683）, respectively. The acute and chronic radiation damage were found to be significantly lighter, the minimum white blood cell counts higher, and the occurrence of peripheral blood toxicity at Ⅱ degree or greater was lower in protection group, as compared with those in control group. CONCLUSIONS： Amifostine has no significant effect on the near-future efficacy of hyperfractionated radiation in combination with the chemotherapy in treating head and neck squamous cell carcinomas, but it can reduce the acute and late radiation damage and plays a role in protecting bone marrow.