TP方案诱导化疗联合调强放疗治疗局部中晚期鼻咽癌的疗效观察

Therapeutic effect of TP regimen induction chemotherapy combined with intensity-modulated radiotherapy for locally advanced nasopharyngeal carcinoma

目的:探讨TP方案诱导化疗联合调强放疗对局部中晚期鼻咽癌患者的临床疗效。方法:选取2012年6月至2015年8月广东省江门市中心医院肿瘤科收治的112例鼻咽癌患者,按随机数字表法分为试验组(n=56)和对照组(n=56)。对照组采取同期调强放化疗,试验组采取3程TP方案诱导化疗联合单独调强放疗。治疗后对比两组临床效果、生活质量改善率、毒副反应发生率和治疗前、后血浆EB病毒DNA(EBV-DNA)阳性率,治疗后随访3年,对比两组无远处转移生存率(DMFS)、无局部复发生存率(LRFS)、无进展生存率(PFS)和总生存率(OS)。结果:治疗3个月后,两组总有效率均为100%;两组治疗后血浆EBV-DNA阳性率均较治疗前降低(均P<0.05),但组间比较差异无统计学意义(P>0.05);两组治疗后DMFS、LRFS、PFS、OS比较,差异均无统计学意义(均P>0.05);与对照组比较,试验组Ⅲ~Ⅳ级白细胞减少、恶心/呕吐发生率降低,生活质量改善率提高(均P<0.05)。结论:与同期调强放化疗相比,采用TP方案诱导化疗联合调强放疗治疗局部中晚期鼻咽癌不仅疗效确切,且可减轻毒副反应,改善生活质量。

Objective: To investigate the effect of TP regimen combined with intensity-modulated radiotherapy on clinical outcomes in patients with locally advanced nasopharyngeal carcinoma. Methods: A total of 112 patients with nasopharyngeal carcinoma admitted to our hospital from June 2012 to August 2015 were enrolled,and randomly divided into a control group and an experimental group,with 56 case in each group.The patients in the control group received concurrent intensity-modulated radiotherapy and chemotherapy,and those in the experimental group received 3-way TP regimen induction chemotherapy combined with intensity-modulated radiotherapy.The clinical effects,life quality,incidence of adverse reactions and plasma EBV-DNA positive rate were compared.All patients were followed-up for 3 years,the distant metastasis survival rate (DMFS),local recurrence survival rate (LRFS),progression-free survival (PFS)and overall survival (OS) were recorded. Results: The total response rate of both groups was 100%.The plasma EBV-DNA positive rate was decreased in both groups after treatment ( P <0.05),but there was no significant difference between the two groups ( P >0.05).There was no significant difference in DMFS,LRFS,PFS and OS between the two groups after treatment( P >0.05).The incidence of grade Ⅲ-Ⅳ leukopenia,nausea and vomiting in the experimental group was lower than that in the control group,while the improvement rate of life quality was higher ( P <0.05). Conclusion: Compared with concurrent intensity-modulated radiotherapy and chemotherapy,TP regimen combined with intensity-modulated radiotherapy for local advanced nasopharyngeal carcinoma is more effective.It can reduce the adverse reactions and improve the quality of life.