甘氨双唑钠(CMNa)对鼻咽癌放疗增敏作用的临床观察

The Clinical Observation of Sodium Glycididazole(CMNa) on Enhancement of Radiation Sensitivity for Nasopharyngeal Cancer

目的评价甘氨双唑钠(CMNa)对局部晚期鼻咽癌的放疗增敏作用及毒副反应。方法将52例经病理确诊的初治鼻咽癌随机分为试验组(甘氨双唑钠+常规放疗)和对照组(单纯常规放疗)。试验组:甘氨双唑钠(CMNa)800 mg/m2的剂量,用100 mL生理盐水稀释溶解后静脉滴注,30 min内滴完,60 min内行常规放疗,每周3次,从放疗开始连续用药至放疗结束,共7周,21次;对照组:放疗方法、程式、剂量与试验组相同。鼻咽部原发灶与颈部淋巴结转移灶照射剂量70 Gy/7周。结果试验组的鼻咽部原发灶和颈淋巴转移灶完全缓解(CR)率分别为88.5%(23/26)和80.8%(21/26),高于对照组的65.4%(17/26)和57.7%(15/26),两组比较差异有统计学意义(P<0.05);试验组达到完全缓解(CR)和部分缓解(PR)的照射剂量低于对照组,鼻咽部原发灶和颈淋巴转移灶疗效达CR时的放射增敏比为1.24和1.20。两组患者治疗的主要毒副反应为黏膜、皮肤、消化道反应和白细胞减少,差异无统计学意义。结论甘氨双唑钠(CMNa)对鼻咽癌的放疗有一定的增敏作用,可提高近期疗效,无明显毒副反应。

Objective To investigate the effect of CMNa on enhancement of radiation sensitivity and toxic reactions of locally advanced nasopharyngeal cancer. Methods 52 patients confirmed by pathology of primary nasopharyngeal cancer were randomly divided into experimental group （CMNa ＋ conventional radiotherapy） and the control group （purely conventional radiotherapy）. Test group： CMNa diluted with 100 mL saline solution was used by intravenously guttae of 800 mg/m^2 in 30 rain, three times a week, a total of seven weeks. These cases were given conventional radiotherapy in 60 min. Control group： all the patient＇s underwent the same radiotherapy as the test group. Nasopharyngeal primary tumor and lymph node metastases of neck were given radiation dose with 70 Gy/7weeks. Results The CR rates of NP in test group and control group were 88.5% and 65.4% respectively. The CR rates of neck lymph node were 80.8% and 57.7% , respectively. There were significant differences between the two groups（ P 〈 0.05）. The test group was given the radiation dose to achieve CR and PR lower than the control group. The radiation sensitizing ratio was 1.24 and 1.20 when the nasopharyngeal lesions and neck metastasis achieved CR. The two groups of the patients had the major toxicity of the mucosa, skin, gastrointestinal reactions and interleukin decline, the difference was not significant. Conclusion CMNa has a certain sensitizing effect of radiotherapy of nasopharyngeal cancer, it may be increase the recent effect, and it does not increase the toxicity.