奈达铂联合氟尿嘧啶诱导化疗加同步放化疗治疗局部晚期鼻咽癌近期疗效观察

The short-term efficacy of induction chemotherapy with nedaplatin combined 5-fluorouracil plus concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma

目的:观察奈达铂联合氟尿嘧啶诱导化疗加同步放化疗治疗局部晚期鼻咽癌的近期疗效及安全性。方法:所有45例局部晚期鼻咽癌患者接受奈达铂联合氟尿嘧啶诱导化疗2个周期,化疗方案为:奈达铂80mg/m2,静滴,d1,氟尿嘧啶500mg/m2,静滴,d1-5,21d为1周期。诱导化疗结束14d后进行放疗,在放疗期间给予奈达铂80mg/m2,静滴,d1,22,43,同步化疗。结果:45例患者中有42例按计划完成治疗,可以评价疗效,2个周期的诱导化疗结束后,鼻咽部原发病灶CR 4例,PR 32例,有效率为85.71%,放化疗结束3月后评价,CR 39例,PR 3例,有效率达100%。35例有颈部淋巴结病灶的均可以评价疗效,2个周期的诱导化疗结束后,CR 4例,PR 27例,有效率为88.57%,放化疗结束3月后评价,CR 34例,PR 1例,有效率达100%。诱导化疗期间不良反应主要为白细胞减少。在同步放化疗期间,主要不良反应为口腔黏膜炎、放射性皮炎,白细胞下降及血小板降低。整个研究中无治疗相关性死亡。结论:奈达铂联合氟尿嘧啶诱导化疗加同步放化疗治疗局部晚期鼻咽癌近期疗效好,不良反应可以耐受,远期效果有待进一步观察。

Objective： To evaluate the short - term efficacy and toxicity of nedaplatin and 5 - fluorouracil induction chemotherapy plus concurrent chemoradiotherapy（CCRT） in the treatment of locally advanced nasopharyngeal carcinoma. Methods： Total 45 patients with locally advanced nasopharyngeal carcinoma were treated with 2 cycles of induction chemotherapy with nedaplatin （ 80mg/m^2, d1 ） and 5 - fluorouracil （ 500mg/me, dI 5 ） followed by 3 cycles of nedaplatin （ 80mg/m^2 , d1,22,43 ） and radiotherapy. Results ： Of 45 patients 42 patients completed induction chemotherapy and subsequent concurrent chemoradiotherapy and were evaluable for treatment response. The overall response rate （ORR） in the primary site were 85.71% [ complete response（CR） in 9.52% ] and 100% [ complete response（CR） in 92.86% ] respectively at completing induction chemotherapy and 3 months after concurrent chemoradiotherpy. In involved nodal stations,the overall response rate were 88.57% [ complete response （CR） in 11.43% ]and 100% complete response（CR） in 97.14% ] at completing induction chemotherapy and 3 months after chemoradiotherapy. The main toxicity was neutropenia during induction chemotherapy. Oral mucositis, skin desquamation, neutropenia and thrombocytopenia were the most common toxicities during chemoradiotherapy. There were no treatment - related deaths during this study. Conclusion： Nedaplatin and 5 - fluorouraeil induction chemotharapy plus concurrent chemoradiotherapy is effective and tolerable in the treatment of locally advanced nasopharyngeal carcinoma. Long - term therapeutic effects of this treatment need further observation.