多西他赛联合奈达铂同步调强适形放疗治疗局部晚期鼻咽癌

Docetaxel plus Nedaplatin Combined with Concurrent Intensity-modulated Radiotherapy in the Treatment of Locally-advanced Nasopharyngeal Carcinoma

目的探讨多西他赛联合奈达铂同步调强适形放疗(IMRT)治疗局部晚期鼻咽癌(NPC)的临床疗效和毒副反应。方法 64例经病理学确诊的初治局部晚期NPC患者随机均分为2组,观察组32例患者行多西他赛联合奈达铂化疗同步IMRT,对照组患者则行奈达铂联合5-氟尿嘧啶化疗同步IMRT。治疗后评价2组临床疗效和毒副反应。结果 2组患者鼻咽大体肿瘤靶区和颈部转移淋巴结体积缩小的百分率比较差异无统计学意义(P>0.05);2组患者NPC病灶和颈部转移淋巴结病灶完全缓解率比较差异均无统计学意义(P>0.05)。观察组Ⅲ、Ⅳ度中性粒细胞减少、恶心或食欲减退、呕吐、腹胀、口腔黏膜反应的发生率均明显低于对照组(P<0.05)。观察组患者1、2 a总生存率和无进展生存率分别为100.00%、96.88%和100.00%、93.75%,对照组分别为100.00%、93.75%和100.00%、90.63%,比较差异均无统计学意义(P>0.05)。结论多西他赛联合奈达铂同步IMRT治疗局部晚期NPC的安全有效,值得在临床上推广应用。

Objective To investigate the clinical effect and toxicities of docetaxel plus nedaplatin combined with concurrent intensity-modulated radiotherapy（ IMRT）in the treatment of locally-advanced nasopharyngeal carcinoma （ NPC）. Methods Sixty-four newly patients with locally-advanced NPC were randomly divided into two groups,32 patients of the observational group were treated by docetaxel plus nedaplatin chemotherapy combined with concurrent IMRT,and 32 patients of the control group were treated by nedaplatin plus 5-fluorouracil chemotherapy combined with concurrent IMRT. The clinical effect and toxicities of the two groups were evaluated comparatively. Results There was no significant difference in the shrinking percentage of nasopharyngeal tumor target and neck metastasis lymph nodes between the two groups（P〉0. 05）. There was no significant difference in the complete remission percentage of NPC and neck metastasis lymph node lesions between the two groups（P〉0. 05）. The incidences of Ⅲand Ⅳ grade neutropenia,nausea or anorexia,vomiting,abdominal distension,oral mucosa reaction of the observational group were significantly lower than those of the control group（P〈0. 05）. The 1-,2-years overall survival and progression free survival rates of the observational group were 100. 00%,96. 88% and 100. 00%,93. 75%;and those of the control group were 100. 00%,93. 75% and 100. 00%,90. 63%,there was no statistically significant difference（P〉0. 05）. Conclusion Docetaxel plus nedaplatin combined with concurrent IMRT is safe and effect in the treatment of locally-advanced NPC.