替吉奥联合同步放疗治疗老年局部晚期鼻咽癌的疗效观察

S-1 combined with concurrent radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma

目的探讨替吉奥联合放疗与单纯放疗治疗老年局部晚期鼻咽癌的疗效和安全性。方法将60例局部晚期鼻咽癌患者(Ⅲ/Ⅳa期)随机分为治疗组(替吉奥+放疗,30例)和对照组(单纯放疗,30例),两组患者均接受常规的放射治疗。治疗组从放射治疗的第1天开始,口服替吉奥60mg,每天2次,第1～28天,休息2周。6周为1个疗程,共治疗4周。结果共55例患者可评价客观疗效和毒副反应。治疗组的有效率为81.4%,明显高于对照组的55.6%(P<0.05)。治疗组的骨髓抑制和胃肠道反应高于对照组(P<0.05),治疗组患者放射性皮炎、放射性口腔黏膜炎与对照组比较,差异无统计学意义(P>0.05)。两组患者的2年无进展生存率分别为88.9%和82.1%,差异无统计学意义(P>0.05)。结论替吉奥联合常规放疗治疗老年局部晚期鼻咽癌,患者耐受性好,且可提高患者的生存时间,值得进一步研究。

Objective To evaluate the efficacy and safety of S-1 combined with concurrent radio- therapy and pure radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma. Methods From April 2009 to January 2010, 60 elderly patients with locally advanced NPC （lll/IVa）were randomly divided into control group （ pure radiotherapy group, n = 30） and treatment group （ concurrent chemoradio- therapy, n = 30）. Radiotherapy was administered in both groups. In treatment group S-1 was given with 80mg/（m2 · d）concurrent with the radiotherapy, from day 1 to day 28 following a 2-week rest. In control group, patients received only radiotherapy. Results A total of 55 patients were eligible. The response rate in treatment group was higher than that in control group（81.4% vs 55. 6% ,P 〈0. 05）. Marrow suppression and gastrointestinal toxicities in treatment group were higher than that in control group. Radiation dermatitis and mucositis in both groups were similar. The 2-year progression-free survival rates in treatment group and control group were 88.9% and 82. 1% , respectively. Conclusions S-1 combined with concurrent radio- therapy is effective and well tolerable for elderly patients with locally advanced nasopharyngeal carcinoma.