放疗联合多西紫杉醇、顺铂同期及辅助化疗治疗局部晚期鼻咽癌的临床观察

A Clinical Study of Docetaxel Combined with Cisplatin Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma

目的观察多西紫杉醇联合顺铂同期放化及辅助化疗治疗局部晚期鼻咽癌的疗效及安全性。方法 2008年1月～2009年12月共48例局部晚期鼻咽癌患者进入研究,放疗总剂量70～76Gy/35～38次,同期于第1、22、43天给予3周期多西紫杉醇+DDP的同期化疗,放疗结束2周后,再给予3周期多西紫杉醇+DDP的辅助化疗。结果中位随访25个月,66.7%的患者完成了全部6周期的化疗,75.0%的患者完成3个周期的同期化疗,70.8%的患者完成了3个周期的辅助化疗。2年局部控制率、总生存率和无进展生存率分别为89.6%、90.1%和77.8%。主要不良反应为中性粒细胞减少、粘膜炎和体重下降,但经过积极支持治疗,大多可完成治疗。结论初步结果表明对于局部晚期鼻咽癌患者,该方案依从性高,早期疗效较好,不良反应可耐受。

Objective To investigate the efficacy and toxicity of docetaxel combined with cisplatin concurrent chemoradiotherapy followed by adjuvant chemotherapy in treatment of patients with locally advanced nasopharyngeal carcinoma. Methods From Jan 2008 to Dec 2009, 48 patients with locally advanced nasopharyngeal carcinoma （NPC） were enrolled in this study. The total radiation dosage was 70 76 Gy in 35 - 38 fi＇actions. Three cycles of concurrent chemoradiotherapy consisting of docetaxel and cisplatin were delivered simultaneously with radiotherapy on the day 1, 22 and 43. Two weeks after radiotherapy, three cycles of adjuvant chemotherapy consisting of the same drugs were also given. Results The median follow-up was 25 months. All patients completed the radiotherapy. 32 patients （66.7%） completed all 6 cycles chemotherapy, 36 patients （75.0%） for 3 cycles concurrent chemotherapy and 34 patients （70.8%） for 3 cycles adjuvant chemotherapy. The 2-year local control rate, the 2-year overall survival rate and the 2-year diseasefree survival rate were 89.6%, 90.1% and 77.8% respectively. The main acute toxicities during therapy were neutropenia, mucositis and weigh loss. Through active support treatment, most patients completed all chemotherapy and radiotherapy. Conclusion The primary results show that for the patients with locally advanced NPC the program has the high compliance and well early effects, and the toxicity is mild and tolerable.