多西他赛与氟尿嘧啶诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的临床分析

Clinical Observation of Docetaxel Combined with Fluorouracil-induced Chemotherapy Combined with Concurrent Chemoradiotherapy for Locally Advanced Nasopharyngeal Carcinoma

目的研究局部晚期鼻咽癌患者实施顺铂+氟尿嘧啶诱导化疗与同期放化疗联合治疗的临床效果。方法选择70例于该院接受局部晚期鼻咽癌治疗的患者,纳入时间为2017年11月—2018年12月,采用随机数字表法将其分为实验组与参照组,每组均35例。其中参照组采用多西他赛+顺铂诱导化疗与同期放化疗联合治疗,实验组行顺铂+氟尿嘧啶诱导化疗与同期放化疗联合治疗,对比2组患者临床疗效、放化疗不良反应、复发及转移情况。结果实验组局部晚期鼻咽癌临床总有效率(85.71%)与参照组(60.00%)相比较高,组间差异有统计学意义(χ^2=5.851 3,P<0.05)。实验组白细胞异常、血小板异常、肝肾功能损伤、恶心呕吐、腹痛腹泻、口腔黏膜炎、放射脑炎、黏膜坏死发生率分别为:85.71%、77.14%、71.43%、85.71%、82.86%、45.71%、22.86%、42.86%,参照组分别为48.57%、45.71%、40.00%、82.86%、42.86%、48.57%、20.00%、17.14%(χ^2=10.943 5、7.295 4、7.005 7、0.107 8、11.993 0、0.057 3、0.084 8、0.084 8,P=0.000 9、0.006 9、0.008 1、0.742 5、0.000 5、0.810 7、0.770 8、0.770 8)。2组恶心呕吐、口腔黏膜炎、放射脑炎、黏膜坏死等放化疗不良反应比例差异无统计学意义(P>0.05),与参照组相比,实验组白细胞异常、血小板异常、肝肾功能损伤、腹痛腹泻等放化疗不良反应率较高,差异有统计学意义(P<0.05)。2组局部晚期鼻咽癌复发或转移比例(65.71%、60.00%)差异无统计学意义(χ^2=0.244 7,P>0.05)。结论多西他赛+顺铂诱导化疗方式在治疗局部晚期鼻咽癌方面具有显著疗效,但其不良反应发生率相对较高,临床中应予以谨慎选择。

Objective To study the clinical effects of cisplatin + fluorouracil-induced chemotherapy combined with concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods Seventy patients who underwent treatment for locally advanced nasopharyngeal carcinoma were enrolled in our hospital. The enrollment time was from November 2017 to December 2018. They were divided into experimental group and reference group by random number table. example. The reference group was treated with docetaxel + cisplatin-induced chemotherapy and concurrent chemoradiotherapy. The experimental group was treated with cisplatin + fluorouracil-induced chemotherapy and concurrent chemoradiotherapy. The clinical efficacy, adverse reactions of radiotherapy and chemotherapy, and recurrence and transfer situation were compared between the two groups. Results The total clinical effective rate (85.71%) of the locally advanced nasopharyngeal carcinoma in the experimental group was higher than that in the reference group (60.00%). There was significant difference between the groups (χ^2=5.851 3, P<0.05). The incidence of leukocyte abnormalities, platelet abnormalities, liver and kidney function damage, nausea and vomiting, abdominal pain and diarrhea, oral mucositis, radiation encephalitis and mucosal necrosis in the experimental group were 85.71%, 77.14%, 71.43%, 85.71%, 82.86%, 45.71%, 22.86%, 42.86%, reference group were 48.57%, 45.71%, 40.00%, 82.86%, 42.86%, 48.57%, 20.00%, 17.14%(χ^2=10.943 5, 7.295 4, 7.005 7, 0.107 8, 11.993 0, 0.057 3, 0.084 8, 0.084 8, P=0.000 9, 0.006 9, 0.008 1, 0.742 5, 0.000 5, 0.810 7, 0.770 8, 0.770 8). There was no difference in the proportion of adverse reactions between the two groups: nausea and vomiting, oral mucositis, radiation encephalitis, and mucosal necrosis (P>0.05), compared with the reference group, the experimental group had abnormal incidence of adverse reactions such as leukocyte abnormalities, platelet abnormalities, liver and kidney function damage, abdominal pain and diarrhea, and had significant differences (P<0.05). There was no difference in the proportion of recurrence or metastasis (65.71%, 60.00%) between the two groups of locally advanced nasopharyngeal carcinoma (χ^2=0.244 7, P>0.05). Conclusion Docetaxel + cisplatin-induced chemotherapy has a significant effect in the treatment of locally advanced nasopharyngeal carcinoma, but the incidence of adverse reactions is relatively high, and should be carefully selected in clinical practice.