CAJ | 학술논문

背景与目的:以铂类为基础联合氟尿嘧啶(5-fluorouracil,5-FU)方案是鼻咽癌患者最常用方案,但患者的疗效一直维持在50%～60%.多西紫杉醇是治疗头颈部恶性肿瘤有效的单药,其给药方式简单、给药时间短.本研究通过比较多西紫杉醇联合卡铂(TC)方案与5-FU联合卡铂(FC)方案对局部晚期鼻咽癌患者的近期疗效和不良反应,探讨局部晚期鼻咽癌诱导化疗的新方案.方法:2005年11月1日至2008年12月1日,58例局部晚期鼻咽癌患者按照相同的临床分期和性别,随机抽签进入试验组和对照组.试验组29例患者采用多西紫杉醇联合卡铂诱导化疗2个疗程后,行2疗程卡铂单药同期放化疗;对照组29例患者采用5-Fu代替多西紫杉醇诱导化疗,余治疗方案同试验组.χ~2检验比较两组患者诱导化疗及同期放化疗的近期疗效和不良反应.结果:试验组的平均化疗周期数比对照组多(3.31 vs.2.83,P=0.043).两组近期疗效及1年总生存率差异均无统计学意义(P>0.05).试验组和对照组Ⅲ度及Ⅲ度以上中性粒细胞减少的发生率分别为72.4%和37.9%,差异有统计学意义(P=0.05).试验组血小板减少和呕吐发生率均较对照组少,差异有统计学意义(P=0.013).结论:TC方案治疗局部晚期鼻咽癌的近期疗效与FC方案相似,不良反应可耐受,远期疗效与毒性尚需进一步研究.
배경여목적:이박류위기출연합불뇨밀정(5-fluorouracil,5-FU)방안시비인암환자최상용방안,단환자적료효일직유지재50%～60%.다서자삼순시치료두경부악성종류유효적단약,기급약방식간단、급약시간단.본연구통과비교다서자삼순연합잡박(TC)방안여5-FU연합잡박(FC)방안대국부만기비인암환자적근기료효화불량반응,탐토국부만기비인암유도화료적신방안.방법:2005년11월1일지2008년12월1일,58례국부만기비인암환자안조상동적림상분기화성별,수궤추첨진입시험조화대조조.시험조29례환자채용다서자삼순연합잡박유도화료2개료정후,행2료정잡박단약동기방화료;대조조29례환자채용5-Fu대체다서자삼순유도화료,여치료방안동시험조.χ~2검험비교량조환자유도화료급동기방화료적근기료효화불량반응.결과:시험조적평균화료주기수비대조조다(3.31 vs.2.83,P=0.043).량조근기료효급1년총생존솔차이균무통계학의의(P>0.05).시험조화대조조Ⅲ도급Ⅲ도이상중성립세포감소적발생솔분별위72.4%화37.9%,차이유통계학의의(P=0.05).시험조혈소판감소화구토발생솔균교대조조소,차이유통계학의의(P=0.013).결론:TC방안치료국부만기비인암적근기료효여FC방안상사,불량반응가내수,원기료효여독성상수진일보연구.
Background and Objective: The platinum-based chemotherapy combined with 5-fluorouracil (5-FU) is most frequently used for nasopharyngeal carcinoma (NPC), but the efficacy has been maintained at 50%-60%. Docetaxel is an effective drug for head and neck tumors, its administration is simple, and the administration time is short. This study was to compare the short-term efficacy and toxicity between TC regimen (inductive chemotherapy with docetaxol plus carboplatin) and FC regimen (5-FU plus carboplatin) in local advanced NPC so as to provide a new chemotherapeutic regimen for NPC. Methods: Fifty-eight local advanced NPC patients without previous treatment in Sun Yat-sen University Cancer Center were randomly assigned to receive either TC regimen or FC regimen treatment. The short-term efficacy and adverse events were observed. Results: More chemotherapy cycles were finished in TC group than in FC group (3.31 vs. 2.83, P=0.043). There was no significant difference in short-term efficacy and 1-year survival rate between the two groups (P >0.05). More Grades 3-4 neutropenia appeared in TC group than in FC group (72.4% vs. 37.9%,P< 0.05), whereas less thrombocytopenia and emesis occurred in TC than in FC group (P= 0.013 and 0.018, respectively).Conclusions: The short-term efficacy of TC regimen in local advanced NPC is similar to that of FC regimen with tolerable adverse events. But the longterm outcomes and toxicities need to be further investigated.