替吉奥胶囊联合三维适形放疗同期治疗局部晚期鼻咽癌临床分析

TS-1 combined with three dimensional conformal radiation therapy(3DCRT) for patients with the locally advanced nasopharyngeal carcinoma

目的探讨替吉奥胶囊(维康达)联合三维适形放疗同期治疗局部晚期鼻咽癌的近期疗效和不良反应。方法局部晚期鼻咽癌患者32例,采用以下方案治疗:化疗:维康达80 mg/(d.m2),分2次餐后口服,放疗第8天开始,连服28 d为1周期,休息2周至放疗结束。放疗:所有患者均为根治性三维适形放疗(3D-CRT),处方剂量GTV 66～70 Gy,共33～35次,颈部预防照射剂量(DT)50 Gy,1次/d,5 d/周。按RECIST1.1标准评价客观疗效和不良反应。结果入组32例患者,31例均完成根治性放疗,1例因进食少低蛋白血症治疗中自动放弃治疗。可评价疗效的31例。CR 19.3%(6/31)、PR77.4%(24/31)、SD 0.03%(1/31),近期有效率96.7%。治疗过程中毒副反应主要为恶心、呕吐、放射性口腔炎和骨髓抑制,没有患者发生4级及以上的毒副反应,无治疗相关死亡。结论维康达联合三维适形放疗同期治疗局部晚期鼻咽癌的近期疗效可靠,不良反应可以耐受,值得临床进一步研究应用。

Objective To evaluate the short-term efficacy and adverse reaction,while TS-1 combined with three dimensional conformal radiation therapy for patients with locally advanced nasopharyngeal carcinoma.Methods Total 32 cases of locally advanced nasopharyngeal carcinoma patients received concurrent chemo-radiation therapy：TS-1 80 mg（d·m2） were given orally twice a day after meal and it began at the eighth day of radiotherapy all the patients received 3D-CRT GTV 66-70 Gy/33-35D.and prophylactic doses 50 Gy to the neck.The efficacy and adverse reaction were evauated according to RECIST1.1.ResultsIn total of 32 cases there are 31 cases completed the radiotherapy and one discontinued because of low lipoprotein.31 cases were evaluable among them.CR 19.3%（6/31）,PR77.4%（24/31）,SD 0.03%（1/31）,short term effective rate 96.7%.The adverse reactions were nausea、vomit、oral mucositis 、bone marrow suppression.No 4 grade drug-related adverse wasobserved.No death patient was found.Conclusion In these cases of TS-1 combined with three dimensional conformal radiation therapy for locally advanced nasopharyngeal carcinoma,the short-term efficacy was good and the late toxicity rate was obviously low.The side effect could be tolerated,It deserves clinic application and futhur stady.