奈达铂联合紫杉醇同步放化疗局部晚期鼻咽癌的临床研究

目的探讨奈达铂联合紫杉醇同步放化疗局部晚期鼻咽癌的应用效果。方法将2011年6月~2013年6月广州市海珠区广东省第二人民医院收治的78例局部晚期鼻咽癌患者按不同治疗方案分为试验组（n=41）,＂奈达铂联合紫杉醇同步放化疗＂方案：（1）奈达铂：100 mg/m2,第1天,静脉滴注,2个疗程;（2）紫杉醇：135mg/m2,第1天,静脉滴注,2个疗程;（3）放疗：肿瘤原发灶与受侵犯淋巴结放疗方案：70~74Gy/35~37次/7周;双侧颈部放疗方案：50Gy/25次/5周）和对照组（n=37）顺铂联合紫杉醇同步放化疗,对2组患者近期疗效及不良反应发生情况进行综合比较。结果 （1）近期疗效：试验组完全缓解率为90.24%（37/41）,对照组完全缓解率为81.08%（30/37）,组间完全缓解率比较差异无统计学意义;（2）不良反应：试验组白细胞减少、血红蛋白减少、胃肠道反应的发生率分别为39.02%、17.07%、12.20%,对照组为64.86%、45.95%、59.46%,组间比较差异有统计学意义（P〈0.05）。结论奈达铂联合紫杉醇同步放化疗局部晚期鼻咽癌效果显著,患者耐受较好。

Objective To investigate the clinical effect of nedaplatin plus paclitaxel combined with radiotherapy for locally advanced nasopharyngeal carcinoma.Methods 78 cases patients with locally advanced nasopharyngeal carcinoma in our hospital from June 2011 to June 2013 were divided into experimental group（n=41）, given“nedaplatin plus paclitaxel combined with radiotherapy”：（1）Nedaplatin：100mg/m2,thefirst day,intravenous drip, two courses;（2）Paclitaxel：135mg/m2,thefirst day,intravenous drip, two courses;（3）radiotherapy：primary tumor and lymph node involvement（70-74Gy/35-37 times/7 weeks）,bilateral neck（50Gy/25 times/5 weeks））and control group（n=37）, given cisplatin plus paclitaxel combined with radiotherapy,the recent efficacy and adverse reactions of two groups were compared.Results（1）Recent efficacy：the CR-rate of experimental group was 90.24%,which was 81.08% of control group,there was no statistically significant difference in CR-rate of two groups;（2） Adverse reactions：the incidence of neutropenia, hemoglobin decreased,gastrointestinal reactions in experimental group was 39.02%,17.07%, 12.20%, which was 64.86%, 45.95%, 59.46% in control group,there was statistically significant difference between two groupsp（P〈0.05）.Conclusion There is a significant effects on nedaplatin plus paclitaxel combined with radiotherapy for locally advanced nasopharyngeal carcinoma,and most patients are tolerable.