单药奈达铂同期放化疗治疗局部晚期鼻咽癌的临床观察

Nedaplatin Plus Concurrent Radiotherapy for Locally Advanced Nasopharyngeal Carcinoma

目的:探讨单药奈达铂同期放化疗治疗局部晚期鼻咽癌的疗效及其不良反应。方法:2008年5月—2010年7月收集的100例符合入组条件的鼻咽癌患者,以随机抽样法分为观察组(奈达铂组)53例、对照组(顺铂组)47例。采用常规分割放射治疗,每次200 cGy,1日1次,1周5日。同期化疗随机采用奈达铂或顺铂30 mg,每周1次。结果:放化疗期间观察组和对照组发生3级以上急性治疗毒性反应分别为32.1%(17/53)、40.4%(19/47)(P>0.05);2组2年总生存率分别为76.2%、83.6%(P>0.05);2组2年无远处转移生存率分别为91.2%、85.1%(P>0.05);2组2年无瘤生存率分别为80.9%、81.3%(P>0.05);2组2年无局部区域复发生存率分别为86.5%、95.5%(P>0.05)。结论:奈达铂联合放疗治疗局部晚期鼻咽癌能达到与顺铂相同的疗效,且不良反应较轻,耐受性好。

OBJECTIVE：To evaluate the efficacy and safety of nedaplatin combined concurrent radiotherapy for locally advanced nasopharyngeal carcinoma.METHODS： From May 2008 to July 2010,100 patients with nasopharyngeal carcinoma meeting inclusion criteria were collected and randomly assigned to either nedaplatin group（n=53） or control group（n=47）.Conventional fraction radiotherapy（200 cGy/ time,q.d,5 days per week） was applied,and nedaplatin or cisplatin（at a dose of 30 mg once a week） was used as concurrent chemotherapy.RESULTS： 32.1%（17/53） of the nedaplatin group vs.32.1%（17/53） of the control group presented with Ⅲ-Ⅳ grade acute toxic reactions（P0.05）,with 2-year overall survival rate of 76.2% vs.83.6%（P0.05）,2-year distance metastasis free survival（DMFS） rate of 91.2% vs.85.1%（P0.05）,2-year disease-free survival（DFS） rate of 80.9% vs.81.3%（P0.05）,and 2-year local recurrence free（LRF） survival rate of 86.5% vs.95.5%（P0.05）.CONCLUSION： Nedaplatin was as effective as cisplatin,well-tolerated and safe when used in combination with concurrent radiotherapy for patients with locally advanced nasopharyngeal carcinoma.