紫杉醇联合顺铂化疗配合放射治疗局部晚期鼻咽癌的疗效观察

Efficacy Observation of Radiotherapy Combined with Chemotherapy of Paclitaxel and Cisplatin for Local Advanced Nasopharyngeal Carcinoma

目的:观察紫杉醇联合顺铂化疗配合放射治疗局部晚期鼻咽癌的临床疗效。方法:将125例局部晚期鼻咽癌患者随机分为治疗组和对照组。治疗组63例先给予1周期的TP方案(紫杉醇135mg.m-2,静脉滴注3h,d1;顺铂20mg.m-2,静脉滴注,d1～5;每3周重复)诱导化疗,休息10d后开始放射治疗,并于放射治疗第1周末、第4周末和第7周末共给予3周期的TP方案同期化疗。对照组62例采用与治疗组相同的单纯放射治疗。治疗后观察2组疗效及不良反应发生情况。结果:治疗组病灶完全消退52例,部分消退6例,有效率为92.1%;对照组病灶完全消退39例,部分消退9例,有效率为77.4%,2组比较差异有统计学意义(P<0.05)。治疗组不良反应发生率高于对照组,且2组骨髓抑制和恶心呕吐的发生率比较差异有统计学意义(P<0.01)。结论:紫杉醇联合顺铂化疗有放射增敏作用,配合放射治疗局部晚期鼻咽癌能改善近期疗效,且毒副反应可以耐受,但长期疗效有待临床进一步观察。

To study clinical efficacy of radiotherapy combined with chemotherapy of paclitaxel and cisplatin for local advanced nasopharyngeal carcinoma （NPC） prospectively. METHODS： 125 patients with advanced local nasopharyngeal carci- noma were randomly divided into 2 groups： 63 patients in treatment group were given TP regimen （paclitaxel 135 mg. m-2 via i.v. gtt 3 h, d1; cisplatin 20 mg-m-2, d1-5; 3 weeks was a cycle） to induce chemotherapy. The radiotherapy was given after 10 days, and 3 cycles of chemotherapy with TP regimen were received at the is＇ weekend, 4th weekend and 7th weekend. 62 patients in con- trol groups were treated by radiotherapy alone. Radiation treatments were same in these 2 groups. RESULTS： There were 52 CR pa- tients and 6 PR patients in treatment group with effective rate of 92.1% ; there were 39 CR patients and 9 PR patients with effective rate of 77.4%. The effective rate of treatment group was significantly higher than that of control group, there was statistical signifi- cance （P〈0.05）. The treatment group had more obvious side-effect of digestive tract and hematology（P〈0.01）, which could be re- lieved after symptomatic treatment. But the patients could be tolerated, and succeed to finish treatment on schedule globally. CON- CLUSIONS： Paclitaxel and cisplatin have radiosensitization. The radiotherapy combined with TP chemotherapy for local advanced nasopharyngeal carcinoma is more effectively in the short term, and the side effects can be tolerated. But the long-term effect is re- mained to be observed.