不同诱导化疗方案治疗局部晚期鼻咽癌的效果比较

Efficacy comparison between different induction chemotherapy regimens for locally advanced nasopharyngeal carcinoma

目的探讨卡培他滨联合多西他赛+顺铂(TP)方案与5-氟尿嘧啶(5-Fu)联合TP方案诱导化疗治疗Ⅲ~ⅣB期鼻咽癌的疗效及不良反应。方法回顾性病例系列研究。收集2020年6月至2021年12月中国科学技术大学附属第一医院收治的65例临床分期Ⅲ~ⅣB期初治鼻咽癌患者的临床资料,所有患者均接受诱导化疗,按照化疗方案不同分为卡培他滨联合TP方案组(卡培他滨组,34例)与5-Fu联合TP方案组(5-Fu组,31例)。比较两组患者的客观缓解率(ORR)及不良反应发生情况。结果卡培他滨组与5-Fu组年龄,性别、T分期及N分期患者构成比,诱导化疗次数比较,差异均无统计学意义(均P>0.05)。卡培他滨组与5-Fu组鼻咽部ORR分别为88.2%(30/34)、74.2%(23/31),差异无统计学意义(χ^(2)=2.12,P=0.145);两组颈部淋巴结ORR分别为85.3%(29/34)、64.5%(20/31),差异无统计学意义(χ^(2)=4.67,P=0.097)。卡培他滨组的消化道反应发生率比5-Fu组低[41.2%(14/34)比71.0%(22/31),χ^(2)=6.45,P=0.040],两组血液学不良反应差异无统计学意义(P>0.05)。结论卡培他滨联合TP方案与5-Fu联合TP方案诱导化疗治疗Ⅲ~ⅣB期鼻咽癌患者的疗效相当,不良反应均可耐受,但卡培他滨联合TP方案消化道反应发生率更低,患者依从性更高,在诱导化疗时可优先考虑卡培他滨联合TP方案。

ObjectiveTo explore the efficacy and adverse reactions of capecitabine combined with docetaxel and cisplatin(TP)regimen or 5-fluorouracil(5-Fu)combined with TP regimen induction chemotherapy for stageⅢ-ⅣB nasopharyngeal carcinoma.MethodsA retrospective case series study was conducted.The clinical data of 65 newly diagnosed nasopharyngeal carcinoma patients with clinical stagesⅢ-ⅣB who were admitted to the First Affiliated Hospital of University of Science and Technology of China from June 2020 to December 2021 were collected.These patients received induction chemotherapy and were divided into capecitabine combined with TP regimen group(capecitabine group,34 cases)and 5-Fu combined with TP regimen group(5-Fu group,31 cases)according to different chemotherapy regimens.The objective response rate(ORR)and the incidence of adverse reactions were compared between the two groups of patients.ResultsThe differences in age,composition ratios of gender,T stage and N stage of patients and induction chemotherapy frequency between the two groups were not statistically significant(all P>0.05).The ORR of nasopharynx in capecitabine group and 5-Fu group were 88.2%(30/34)and 74.2%(23/31),and the difference was statistically significant(χ^(2)=2.12,P=0.145);the ORR of cervical lymph nodes were 85.3%(29/34)and 64.5%(20/31),with no statistically significant difference(χ^(2)=4.67,P=0.097).The incidence of gastrointestinal reactions in the capecitabine group was lower than that in the 5-Fu group[41.2%(14/34)vs.71.0%(22/31),χ^(2)=6.45,P=0.040],and the difference in the hematological adverse reaction between the two groups was not statistically significant(P>0.05).ConclusionsThe efficacy of capecitabine combined with TP regimen and 5-Fu combined with TP regimen induction chemotherapy for stageⅢ-ⅣB nasopharyngeal carcinoma patients is comparable,and the adverse reactions are tolerable.However,the capecitabine combined with TP regimen has lower incidence of gastrointestinal reactions and higher compliance by the patients.Therefore,the capecitabine combined with TP regimen can be prioritized in the induction chemotherapy.