多西紫杉醇联合放疗治疗中晚期鼻咽癌临床观察

The clincal observation on the effect of advanced nasopharyngeal carcinoma treated by Docetaxel combined with radiotherapy

目的:观察多西紫杉醇联合放疗治疗局部中晚期鼻咽癌的近期疗效和毒副反应。方法:确诊的77例Ⅲ期及Ⅳa期初治鼻咽癌患者随机分为单纯放疗组(单放组)38例和同步放化疗组(放化组)39例,两组放射治疗剂量及方式相同,放化组同时采用国产多西紫杉醇50mg/m2静滴,每周一次,治疗结束后评价疗效。结果:放化组和单放组患者鼻咽部病灶消退率为92.3%、73.7%,颈部转移淋巴结消退率分别为96.6%和77.8%,差异有显著意义(P<0.05);放化组和单放组胃肠道反应的发生率分别为74.4%和39.5%,有明显统计学意义(P<0.05)。骨髓抑制和皮肤、口腔黏膜急性反应发生率相近。结论:多西紫杉醇联合放疗可提高局部中晚期鼻咽癌原发灶及颈部转移淋巴结的消退率,而毒副反应无明显增加。

Objective：To observe the short -term efficacy and adverse reaction of docetaxel combined with radiotherapy for locally advanced nasopharyngeal carcinoma. Methods： 77 patients with stage Ⅲ and Ⅳ, NPC were randomly allocated into two groups： radiotherapy alone group （38 cases）and radiotherapy plus chemotherapy group （39 cases）. Similar dosage and fractionation of radiotherapy was administered in both groups. The patients of radiotherapy plus chemotherapy group reveived docetaxel 50mg/m2, once a week. Results： The regression rate for primary tumor were 92.3% in the radiotherapy plus chemotherapy group, and 73.7% in radiotherapy alone group. The remission rate in the cervical lymph nodes were 96.6% VS 77.8 %, both with significant difference （ P 〈 0.05 ）. The gastrointestinal reaction of radiotherapy plus chemotherapy group were higher than the incidence of response to radiotherapy alone group, 74.4% VS 39.5%, there are clear statistical significance（P 〈 0.05 ）. Bone marrow suppression and reaction of skin and oral mucosa membrane were similar. Conclusion： Docetaxel combined with radiotherapy can increase the regression rate of primary tumor and cervical lymph nodes of locally advanced nasopharyngeal, and no significant toxicity increase.