中晚期鼻咽癌奈达铂诱导化疗与同步放化疗的临床对比观察

Clinical study of concurrent radiotherapy and chemotherapy or induction chemotherapy with nedaplatin for advanced nasopharyngeal carcinoma

目的:观察奈达铂每周同步放化疗与奈达铂+氟尿嘧啶诱导化疗联合放疗治疗中晚期鼻咽癌的近期疗效和毒副反应。方法:52例中晚期鼻咽癌患者随机分为同步放化疗组(A组)和诱导化疗+放疗组(B组)。A组接受奈达铂单药每周一次同步化疗,B组接受奈达铂联合氟尿嘧啶诱导化疗两周期+放疗。结果:放疗结束及3个月后近期疗效观察。放疗结束时有效率A组为95.8%,B组为92.8%,完全缓解率A组为79.2%,B组为60.7%。放疗3个月后A组有效率为95.8%,B组为96.4%,完全缓解率A组为83.3%,B组为82.1%。毒性反应:III-IV级口腔黏膜反应A组为12.5%,B组为7.1%;III-IV级白细胞及粒细胞减少A组为16.7%,B组为7.1%。结论:对中晚期鼻咽癌,含奈达铂方案同步放化疗近期疗效优于诱导化疗+放疗,病人耐受性较好,远期疗效还有待进一步观察。

Objective：To compare the effect and toxic reaction of concurrent radiotherapy and chemotherapy or in-duction chemotherapy with nedaplatin for advanced nasopharyngeal carcinoma. Methods：All 52 patients with ad-vanced nasopharyngeal carcinoma were randomized into two groups：concurrent radiotherapy and chemotherapy group （ Group A）,induction chemotherapy group（ Group B）. The patients in Group A were treated by weeky nedaplatin bi-side radiotherapy,the patients in Group B treated by 2 cycles of induction chemotherapy with nedaplatin plus 5-flu-orourac before radiotherapy. Results：The recent effect：the end of radiotherapy an after three months,in Group A,CR rates were 79. 2% and 83. 3%,CR﹢PR rates were both 95. 8%. In Group B,CR rates were 60. 7% and 82. 1%,CR A were 12. 5% and 16. 7%,in Group B were both 7. 1%. Conclusion：For advanced nasopharyngeal carcinoma,concurrent radiotherapy and chemotherapy with nedaplatin is more effective than induction chemotherapy,patients were well tolerated.