CAJ | 학술논문

目的比较1个疗程TPF方案和2个疗程PF方案作为诱导化疗对局部N晚期鼻咽癌的近期疗效和患者不良反应.方法收集2007年1月至2008年12月初治的47例接受过诱导化疗的局部N晚期鼻咽癌患者,其中采用1个疗程TPF诱导化疗方案26例,采用2个疗程PF诱导化疗方案21例;唧方案使用多西紫杉醇(Docetaxel,TAX,商品名:泰素帝)60mg/m2,静脉滴注,第1天;顺铂(DDP)80mg/m2,静脉滴注,第1天;5-氟尿嘧啶(5-Fu)800mg/m2,第1天至第4天,静脉泵注.PF方案使用DDP 100 mg/m2,静脉滴注,第1天;5-Fu 1000 mg/m2,第1天至第4天,静脉泵注;两组均为3周方案.随后两组均采用DDP(30 mg/m2,每周方案)单药为基础的同期放化疗.观察比较两组患者的近期疗效和不良反应.结果试验组诱导化疗后鼻咽部病灶有效率(CR+PR)57.7%;颈部有效率69.2%,对照组2个疗程PF方案诱导化疗后鼻咽部病灶有效率66.7%;颈部有效率71.4%(P>0.05).治疗后3个月试验组鼻咽部病灶和颈部淋巴结CR率分别为92.3%和88.7%,而对照组鼻咽部病灶和颈部淋巴结CR率分别为100.0%和90.5%(P>0.05).试验组治疗不良反应主要是中性粒细胞减少和脱发.结论 1个疗程TPF诱导化疗对局部N晚期鼻咽癌可取得较好的局部控制率,中性粒细胞减少是主要的治疗毒性.
목적 비교1개료정TPF방안화2개료정PF방안작위유도화료대국부N만기비인암적근기료효화환자불량반응.방법 수집2007년1월지2008년12월초치적47례접수과유도화료적국부N만기비인암환자,기중채용1개료정TPF유도화료방안26례,채용2개료정PF유도화료방안21례;즉방안사용다서자삼순(Docetaxel,TAX,상품명:태소제)60mg/m2,정맥적주,제1천;순박(DDP)80mg/m2,정맥적주,제1천;5-불뇨밀정(5-Fu)800mg/m2,제1천지제4천,정맥빙주.PF방안사용DDP 100 mg/m2,정맥적주,제1천;5-Fu 1000 mg/m2,제1천지제4천,정맥빙주;량조균위3주방안.수후량조균채용DDP(30 mg/m2,매주방안)단약위기출적동기방화료.관찰비교량조환자적근기료효화불량반응.결과 시험조유도화료후비인부병조유효솔(CR+PR)57.7%;경부유효솔69.2%,대조조2개료정PF방안유도화료후비인부병조유효솔66.7%;경부유효솔71.4%(P>0.05).치료후3개월시험조비인부병조화경부림파결CR솔분별위92.3%화88.7%,이대조조비인부병조화경부림파결CR솔분별위100.0%화90.5%(P>0.05).시험조치료불량반응주요시중성립세포감소화탈발.결론 1개료정TPF유도화료대국부N만기비인암가취득교호적국부공제솔,중성립세포감소시주요적치료독성.
Objective To compare the short-term effects and toxicity of one cycle of TPF regimen induction chemotherapy with that of two cycles of PF regimen induction chemotherapy in the N advanced local nasopharyngeal carcinoma (NPC). Methods A total of 47 patients initially treated with N advanced local NPC without distant metastasis from Jan 2007 to Dec 2008 were enrolled in this study. The TPF chemotherapy regimen was administered as follows: TAX 60 mg/m2, i.v. infusion on day 1st, cisplatin 80 mg/m2, i.v. infusion on day 1st and 5-Fu 800 mg/m2, bolus infusion in 96 hours on day lst-4th. The PF chemotherapy regimen was as follows: cisplatin 100 mg/m2, i.v. infusion on day 1 and 5-Fu 1000 mg/m2, bolus infusion in 96 hours on day lst-4th. Twenty-six patients received one cycle of TPF regimen and 21 patients received two cycles of PF regimen, with 21 days each cycle and a total of 3 courses in each group, then chemoradiotherapy with cisplatin 30 mg/m2 (weekly) was followed. Results The short-term efficacy was no significant difference between two groups, after one cycle TPF chemotherapy, the CR+PR rates of primary site and lymph nodes were 57.7 % and 69.2 %, respectively, while after two cycles PF chemotherapy in control group, those were 66.7 % and 71.4 %, respectively (P>0.05). In 3 months after treatment, the CR rates of primary site and lymph nodes in TPF group were 92.3 % and 88.7 %, respectively, while those in control group were 100.0 % and 90.5 %, respectively (P>0.05). The main adverse reactions were Grade Ⅲ-Ⅳ neutropenia and alopecia in TPF group. Conclusion Short-term effects of induction chemotherapy with one cycle of TPF regimen in the N advanced local NPC is satisfied, and the main toxicity is neutropenia.