局部晚期鼻咽癌BPP方案同期放化疗与常规放化疗比较

BPP Concurrent Chemoradiotherapy vs.Conventional Chemoradiotherapy for Locoregionally Advanced Na-sopharyngeal Carcinoma

目的:比较BPP方案同期放化疗加辅助化疗和PF方案诱导化疗加放疗加辅助化疗在局部晚期鼻咽癌治疗的效果与毒副作用。方法:回顾性分析154例接受放化结合治疗的局部晚期鼻咽癌患者。其中74例采用BPP方案同期放化疗加辅助化疗(A组);80例采用PF方案诱导化疗加放疗加辅助化疗(B组)。放疗采用常规技术。结果:全程治疗结束后3mo肿瘤疗效评价:A、B组完全缓解率分别为97·3%、88·8%(P<0·05),3a总生存率分别为79·7%、76·4%(P>0·05),无远处转移生存率分别为72·8%、74·9%(P>0·05),无疾病进展生存率分别为71·7%、66·7%(P>0·05)。A组和B组2～3级恶心、呕吐发生率分别为47·3%、57·5%(P>0·05),白细胞减少的发生率分别为43·3%、27·5%(P<0·05),皮肤反应发生率分别为73·0%、87·5%(P<0·05),口腔黏膜反应发生率分别为66·2%、86·2%(P<0·01)。结论:采用BPP方案同期放化疗治疗局部晚期鼻咽癌近期疗效优于PF方案。3a生存率2组无差异。A组血液毒性较高,B组皮肤黏膜反应较重。

OBJECTIVE： To compare the efficacy and toxicity of BPP concurrent chemoradiotherapy（CCRT） followed by adjuvant chemotherapy with PF induction chemotherapy plus radiotherapy followed by adjuvant chemotherapy in locoregionally advanced nasopharyngeal carcinoma（NPC） .METHODS： 154 patients with locoregionally advanced NPC receiving radlo- and chemotherapy were analyzed retrospectively.Of whom, 74 were assigned to receive BPP（Bleomycin, Pirarubicin and Cisplatin） and chemoradiotherapy（CCRT） concomitantly followed by adjuvant chemotherapy（Group A）, 80 to receive PF（Cisplatin and 5-FU） induction chemotherapy plus radiotherapy and adjuvant chemotherapy（Group B） .In radiotherapy（RT） conventional technique was applied.RESULTS： The clinical efficacy was evaluated 3 months after the termination of the whole range treatment.For Group A vs.Group B：the CR was 97.3% vs.88.8% （P〈0.05）;3 year survival was 79.7% vs.76.4% （P〉0.05）; distant metastasis-free survival was 72.8% vs.74.9% （P 〉 0.05）; progression-free survival was 71.7% vs.66.7% （P 〉 0.05）; incidence of nausea and vomiting（2--3 grade）was 47.3% vs. 57.5% （P 〉 0.05）; incidence of aleucocytosis was 43.3% vs. 27.5% （P〈0.05）; incidence of skin toxicity was 73.0% vs.87.5% （P〈0.05）, and the incidence of oral mucosal toxicity was 66.2 % vs. 86.2 % （P 〈 0.01） . CONCLUSION ： The short - term efficacy of BPP concurrent chemoradiotherapy （CCRT） is superior to PF scheme in the treatment of locoregionally advanced nasopharyngeal carcinoma（NPC） .There was no significant difference in 3-year survival between two groups.The hematological toxicity was more serious in Group A, while the toxic reactions in skin and mucosa were more serious in Group B.