紫杉醇与5-氟尿嘧啶分别联合奈达铂治疗晚期鼻咽癌的临床观察

Clinical Observation of Paclitaxel or 5-Fluorouracil Combined with Nadaplatin in the Treatment of Advanced Nasopharyngeal Carcinoma

目的:观察紫杉醇与5-氟尿嘧啶分别联合奈达铂治疗晚期鼻咽癌(NPC)的临床疗效及安全性。方法:将42例晚期NPC患者按随机数字表法分为观察组和对照组,各21例。两组患者均同步进行放疗。与此同时,观察组患者化疗方案为紫杉醇135mg/m^2,d1,联合奈达铂80 mg/m^2,d2~4;对照组患者化疗方案为5-氟尿嘧啶500 mg/m^2,d1~5,联合奈达铂80 mg/m^2,d1~3。3周为1个疗程,两组患者均治疗2个疗程。观察两组患者临床疗效、生存率及不良反应。结果:观察组患者总有效率为95.2%,与对照组的90.5%比较,差异无统计学意义(P>0.05);观察组患者3年总生存率和无进展期生存率分别为81.0%和71.4%,对照组分别为76.2%和66.6%,组间比较差异均无统计学意义(P>0.05)。观察组患者恶心、呕吐发生率明显低于对照组,口腔黏膜炎症发生率明显高于对照组,差异有统计学意义(P<0.05)。结论:紫杉醇与5-氟尿嘧啶分别联合奈达铂治疗晚期NPC疗效相当,治疗中应严密监测患者不良反应并及时给予对症处理。

OBJECTIVE： To observe clinical efficacy and safety of paclitaxel or 5-fluorouracil combined with nadaplatin in the treatment of advanced nasopharyngeal carcinoma（NPC）. METHODS： 42 patients with advanced NPC were randomly divided into observation group and control group（n=21）. 2 groups of patients were treated with radiotherapy. Observation group received chemotherapy of paclitaxel（135 mg/m^2,d1）and nedaplatin（80 mg/m^2,d 2-4）;control group received chemotherapy of 5-fluorouracil（500 mg/m^2,d1-5）and nedaplatin（80 mg/m^2,d1-3）;a treatment course lasted for 3 weeks,and both groups received 2 courses of treatment. Clinical efficacy, survival rate and ADR were observed in 2 groups. RESULTS：The overall response rate was 95.2%in observation group and 90.5% in control group,with no significant difference between 2 groups（P〉0.05）. The 3-year overall survival rate and progression-free survival rate were 81.0% and 71.4% in observation group and 76.2% and 66.6% in control group,with no significant difference（P〈0.05）. The incidence of nausea and vomiting in observation group were lower than in control group,while the incidence of oral mucosa inflammation was higher than control group,with statistical significance（P〈0.05）.CONCLUSIONS：The chemoradiotherapy of paclitaxel or 5-fluorouracil combined with nadaplatin have similar therapeutic efficacy for advanced NPC. ADR by chemoradiotherapy should be monitored closely and treated timely.