紫杉醇脂质体+洛铂及氟尿嘧啶诱导化疗及同期放化治疗局部晚期鼻咽癌的临床研究

Clinical Study of Paclitaxel Liposome+Lobaplatin and Fluorouracil Induced Chemotherapy and Concurrent Radiochemical Therapy for Locally Advanced Nasopharyngeal Carcinoma

目的:探讨紫杉醇脂质体+洛铂及氟尿嘧啶诱导化疗及同期放化治疗局部晚期鼻咽癌的临床效果。方法:选取2016年6月-2018年6月本院收治的90例局部晚期鼻咽癌患者。按照随机数字表法将其分为对照组(多西紫杉醇+顺铂+5-氟尿嘧啶诱导化疗加顺铂同期放化疗方案)和研究组(紫杉醇脂质体+洛铂+5-氟尿嘧啶诱导化疗加洛铂同期放化疗方案),每组各45例。于治疗结束后,行鼻咽和颈部MRI检查,评估疗效,并记录治疗期间患者出现的毒副反应。结果:两组鼻咽肿瘤、颈部淋巴结的治疗总有效率比较,差异均无统计学意义(P>0.05);研究组中性粒细胞减少程度、口腔黏膜炎情况均优于对照组(P<0.05),两组贫血、血小板减少、胃肠道反应、肝毒性等毒副反应比较,差异均无统计学意义(P>0.05)。结论:紫杉醇脂质体+洛铂+5-氟尿嘧啶诱导化疗加洛铂同期放化疗方案与多西紫杉醇+顺铂+5-氟尿嘧啶诱导化疗加顺铂同期放化疗方案治疗局部晚期鼻咽癌的近期疗效相当,但前者不良反应较传统方案明显减少,耐受性更佳。

Objective:To investigate the clinical effects of Paclitaxel Liposome+Lobaplatin and Fluorouracil induced chemotherapy and concurrent radiotherapy for locally advanced nasopharyngeal carcinoma.Method:A total of 90 patients with locally advanced nasopharyngeal carcinoma admitted to our hospital from June 2016 to June 2018 were selected.According to the random number table method,they were divided into control group(Docetaxel+Cisplatin+5-fluorouracil induction chemotherapy plus Cisplatin concurrent chemoradiotherapy regimen)and study group(Paclitaxel Liposome+Lobaplatin+5-fluorouracil induced chemotherapy plus Lobaplatin concurrent chemoradiotherapy),45 cases in each group.At the end of treatment,nasopharyngeal and cervical MRI was performed to evaluate the efficacy,the toxic and side effects during the treatment were recorded.Result:There was no significant difference in total effective rate of nasopharyngeal tumors and cervical lymph nodes between two groups(P>0.05).The degree of neutropenia and oral mucositis in study group were better than those of control group(P<0.05).There was no significant difference in toxicity and side effects of anemia,thrombocytopenia,gastrointestinal reaction and hepatotoxicity between two groups(P>0.05).Conclusion:The short-term efficacy of Paclitaxel Liposome+Lobaplatin+5-fluorouracil induced chemotherapy plus Lobaplatin concurrent chemoradiotherapy is similar to that of Docetaxel+Cisplatin+5-fluorouracil induction chemotherapy plus Cisplatin concurrent chemoradiotherapy regimen in treatment of locally advanced nasopharyngeal carcinoma,but the former has fewer adverse reactions and better tolerance.