4种化疗方案治疗晚期鼻咽癌的临床观察

Evaluation the efficacy of four regimens on treating patients with advanced nasopharyngeal carcinoma

目的评价顺铂+5-氟尿嘧啶(PF)、多西紫杉醇+顺铂+5-氟尿嘧啶(DPF)、吉西他滨+顺铂(GP)和紫杉醇+卡铂(TC)等4种方案治疗晚期及复发转移鼻咽癌的近期疗效及毒副反应。方法同一化疗方案的病例列为1组。PF组19例,DPF组22例,GP组23例,TC组23例。分别总结4种方案的有效率、白细胞下降和恶心呕吐的发生率。并将DPF、GP、TC方案分别与PF方案的各项结果进行统计分析。结果 PF组、DPF组、GP组和TC组的有效率分别为42.11%、72.73%、78.26%、56.5%。DPF方案、GP方案有效率与PF方案相比差异有统计学意义(χ2=3.939,P=0.047和χ2=5.768,P=0.016)。Ⅲ～Ⅳ度白细胞下降发生率GP、TC方案与PF方案比较差异无统计学意义(P>0.05);而DPF方案较PF方案差异有统计学意义(χ2=12.897,P=0.001)。恶心呕吐的发生率4组方案均差异无统计学意义(P>0.05)。结论 :DPF、GP、TC方案均是治疗晚期及复发、转移鼻咽癌可供选择的化疗方案。

Objective To evaluate the short-term therapeutic effect,toxicity and side effects of Cisplatin＋5-Fluorouracil（PF）regimen,Docetaxel＋Cisplatin＋5-Fluorouracil（DPF）regimen,Gemcitabine＋Cisplatin（GP）regimen,and Paclitaxel＋CBP（TC）regimen on treating advanced and recurrent nasopharyngeal carcinoma（NPC）.Methods Nineteen cases were treated with PF regimen,22 cases with DPF regimen,23 cases with GP regimen and 23 cases with TC regimen.The response rate,the occurrence of leukocytopenia,nausea and vomiting in each group were calculated and statistically analyzed.Result The response rates of PF,DPF,GP,and TC regimen were 42.11%,72.73%,78.26% and 56.5%,respectively.The higher response rates in the regimens of DPF and GP comparing to regimen PF were statistically significant（χ^2=3.939,P=0.047;χ^2=5.768,P=0.016）.The occurrence rate of Ⅲ～Ⅳ grade leukocytopenia was no significantly different among the GP,TC and PF regimens（P〈0.05）.The difference between regimen DPF and PF was statistically significant（χ^2=12.897,P=0.001）.The differences of occurrence of nausea and vomiting among the four groups had no statistically significant（P〈0.05）.Conclusion DPF,GP and TC are effective chemotherapy regimens for advanced and recurrent NPC.