放疗加紫杉醇化学治疗晚期鼻咽癌前瞻性研究

PROSPECTIVE AND RANDOMIZED STUDY OF PACLITAXEL CAPSULE COMBINED WITH RADIOTHERAPY FOR ADVANCED NASOPHARYNGEAL CARCINOMA OF N_2 AND N_3

目的 :观察晚期鼻咽癌放疗并紫杉醇胶囊口服化疗的近期疗效、3年生存率及急性不良反应。方法 :80例晚期鼻咽癌患者 ,随机分为单纯放疗组 (对照组 )和放疗联合紫杉醇胶囊口服化疗组 (治疗组 ) ,进行近期疗效、3年生存率及不良反应对比 ,两组放疗方法相同。治疗组在放疗前 3d开始口服紫杉醇胶囊每次 2粒 ,3次 /d ,连用直至放疗结束。结果 :治疗组局部肿瘤消退时放疗剂量显著低于单纯放疗组 (P <0 .0 5 )。放疗结束时CR评价及 3年生存率治疗组较对照组高 ,有统计学差异 (P <0 .0 5 )。治疗组急性不良反应较对照组增加 ,但无统计学差异 ((P >0 .0 5 )。)结论 :紫杉醇胶囊口服对晚期鼻咽癌放疗有增敏作用 ,可提高晚期鼻咽癌近期局部控制率及 3年生存率 ,急性不良反应尚可接受。

Objective:To observe the short-term curative effects, the survival rate of 3-year and the acute adverse effects of paclitaxel capsule combined with radiotherapy for advanced nasopharyngeal carcinoma .Methods:Eighty patients with advanced nasopharyngeal carcinoma of N 2 and N 3 were randomily dirided into paclitaxel capsule combined with radiotherapy (treatment group ) and mere radiotherapy group (control group) . The short-term curative effects, the survival rate of 3-year and the acute adverse effects in these two groups were compared.Radiotherapy in both groups was performed with the same method, only in the treatment group paclitaxel capsule (2 capsules tid orally) was given three day prior to the radiotherapy and it was continued until the end of radiotherapy.Results:The radiation dosage for remission of local tumor was much lower in the treatment group than that in the mere radiotherapy group ( P <0.05). The CR after completion of radiotherapy and the survival rate of 3-year were higher in the treatment group than that in the mere radiotherapy group, the difference was significant. The adverse effects increased in the treatment group, but the patients were able to endure. The adverse effects associated with paclitaxel capsule did not increase significantly.Conclusions:Paclitaxel capsule can enhance radiosensitivity in treatment for advanced nasopharyngeal carcinoma of N 2 and N 3 by means of radiotherapy. The short-term local control rate and the survival rate of 3-year may be improved, and the patients can endure the acute adverse effects caused by this treatment.