甘氨双唑钠对ⅣB期鼻咽癌后半程放射治疗增敏的临床研究

Clinical research of radiosensitization by CMNa on nasopharyngeal carcinoma of stage ⅣB

目的:探讨甘氨双唑钠(CMNa)在ⅣB期鼻咽癌放射治疗的增敏作用和临床应用价值。方法:选择ⅣB期鼻咽癌,面颈联合野加双下颈前后对穿照射36Gy后,颈部转移淋巴结残留≥5cm的患者40例,分为前瞻性分析试验组(CMNa+放疗)和对照组各20例。试验组采用CMNa800mg/m2,用100mL生理盐水稀释溶解,于30min内静脉滴完,在60min内进行3D-CRT放疗。对照组仅行3D-CRT放疗。结果:放疗70Gy结束后,评定疗效,颈部转移淋巴结缓解率(CR+PR):试验组90%(18/20),对照组55%(11/20),P=0.01;原发灶(T)缓解率:试验组95%(19/20),对照组65%(13/20),P=0.02。结论:CMNa对鼻咽癌有良好的放疗增敏作用,特别是对于颈部淋巴结转移灶大的患者,近期疗效明显,且药物耐受性好。远期效果有待进一步观察。

OBJECTIVE： To evalution the role of CMNa in enhancing radiosensitivity and its safety on the radiotherapy for nasopharyngeal carcinoma of stage ⅣB. METHODS： A total of 40 patients with nasopharyngeal carcinoma, the lymph of cervix ≥5 cm after 36 Gy irradiation were detected, and 40 patients were randomly divided into CMNa＋radiotherapy group（20） and cotrol groups （20）. Diagnosis in all cases was confirmed by pathology. The test group were intravenous dripped CMNa 800 mg/m^2, with 100 mL NS in 30 min, during treatment period by 3DCRT in 60 min. Patients in control were only treated with 3D-CRT. RESULTS： The treatment outcome was detected after radiotherapy for 70 Gy. The CR rate in the primary site of test group（95%, 19/20） was higher than that of control group（65%, 13/20,P 0.02）. The CR＋PR rate in the lymph of cervix of test group（90%, 18/20） was higher than that of group control （55%, 11/20,P=0.01）. CONCLUSIONS： A positive role for enhancing radiosensitivity of nasopharyngeal carcinoma may be indicated, especially grand lymph in cervix. CMNa combined with radiotherapy is well tolerated. Further study on its sensitizing effect is warranted.