临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
9期
25-28
,共4页
迟峰%肖玉平%曾越灿%陈佳佳%吴荣%邢锐%蔡炜嵩%吴丽娜%王思亮%陈欢欢
遲峰%肖玉平%曾越燦%陳佳佳%吳榮%邢銳%蔡煒嵩%吳麗娜%王思亮%陳歡歡
지봉%초옥평%증월찬%진가가%오영%형예%채위숭%오려나%왕사량%진환환
喉肿瘤%放化疗%紫杉醇%顺铂%氟尿嘧啶
喉腫瘤%放化療%紫杉醇%順鉑%氟尿嘧啶
후종류%방화료%자삼순%순박%불뇨밀정
Laryngeal neoplasms%Chemoradiotherapy%Paclitaxel%Cisplatin%Fluorouracil
目的：观察紫杉醇加顺铂( TP)方案与顺铂加氟尿嘧啶( PF)方案化疗同步放疗对局部晚期喉癌的效果和毒性及不良反应。方法将局部晚期喉癌47例随机分为TP化疗同步放疗组( TP组)24例和PF化疗同步放疗组(PF组)23例。两组均予常规放疗,方法相同,原发灶及转移淋巴结放射耐受剂量( DT)60~70 Gy/6~7周(2.0 Gy/d,每周5次)。放疗同时予2周期化疗,放疗结束后继续完成2周期化疗,共4周期。 TP 组予紫杉醇135 mg/m2静脉滴注(第1天)、顺铂25 mg/m2静脉滴注(第1~3天),28 d为1个周期；PF组予顺铂25 mg/m2静脉滴注(第1~3天)、氟尿嘧啶500 mg/m2静脉注射(第1~5天),28 d为1个周期。治疗结束后观察近期疗效、毒性及不良反应发生情况,随访5年观察生存期。结果两组近期疗效比较差异有统计学意义( P<0.05)；TP组与PF组的放射性咽喉炎、胃肠道反应及骨髓抑制情况比较差异均有统计学意义(P<0.05)；中位生存时间TP组2.4年,PF组2.0年,差异无统计学意义(P>0.05)。结论 TP方案化疗同步放疗治疗局部晚期喉癌有效率较高,患者耐受性良好。
目的：觀察紫杉醇加順鉑( TP)方案與順鉑加氟尿嘧啶( PF)方案化療同步放療對跼部晚期喉癌的效果和毒性及不良反應。方法將跼部晚期喉癌47例隨機分為TP化療同步放療組( TP組)24例和PF化療同步放療組(PF組)23例。兩組均予常規放療,方法相同,原髮竈及轉移淋巴結放射耐受劑量( DT)60~70 Gy/6~7週(2.0 Gy/d,每週5次)。放療同時予2週期化療,放療結束後繼續完成2週期化療,共4週期。 TP 組予紫杉醇135 mg/m2靜脈滴註(第1天)、順鉑25 mg/m2靜脈滴註(第1~3天),28 d為1箇週期；PF組予順鉑25 mg/m2靜脈滴註(第1~3天)、氟尿嘧啶500 mg/m2靜脈註射(第1~5天),28 d為1箇週期。治療結束後觀察近期療效、毒性及不良反應髮生情況,隨訪5年觀察生存期。結果兩組近期療效比較差異有統計學意義( P<0.05)；TP組與PF組的放射性嚥喉炎、胃腸道反應及骨髓抑製情況比較差異均有統計學意義(P<0.05)；中位生存時間TP組2.4年,PF組2.0年,差異無統計學意義(P>0.05)。結論 TP方案化療同步放療治療跼部晚期喉癌有效率較高,患者耐受性良好。
목적：관찰자삼순가순박( TP)방안여순박가불뇨밀정( PF)방안화료동보방료대국부만기후암적효과화독성급불량반응。방법장국부만기후암47례수궤분위TP화료동보방료조( TP조)24례화PF화료동보방료조(PF조)23례。량조균여상규방료,방법상동,원발조급전이림파결방사내수제량( DT)60~70 Gy/6~7주(2.0 Gy/d,매주5차)。방료동시여2주기화료,방료결속후계속완성2주기화료,공4주기。 TP 조여자삼순135 mg/m2정맥적주(제1천)、순박25 mg/m2정맥적주(제1~3천),28 d위1개주기；PF조여순박25 mg/m2정맥적주(제1~3천)、불뇨밀정500 mg/m2정맥주사(제1~5천),28 d위1개주기。치료결속후관찰근기료효、독성급불량반응발생정황,수방5년관찰생존기。결과량조근기료효비교차이유통계학의의( P<0.05)；TP조여PF조적방사성인후염、위장도반응급골수억제정황비교차이균유통계학의의(P<0.05)；중위생존시간TP조2.4년,PF조2.0년,차이무통계학의의(P>0.05)。결론 TP방안화료동보방료치료국부만기후암유효솔교고,환자내수성량호。
Objective To explore the therapeutic effects and adverse effects of the two regimens:paclitaxel and cis-platin ( TP regimen) , cisplatin and fluorouracil ( PF regimen) , both with concurrent radiotherapy for the treatment of locore-gionally advanced laryngeal cancer. Methods Forty-seven patients with locoregionally advanced laryngeal cancer were ran-domly divided into the TP group (n=24) and the PF group (n=23). All the patients received conventional radiotherapy at a total dose of 60-70 Gy in primary tumor and metastatic lymph nodes for 6-7 weeks (2. 0 Gy/d, 5 times per week). Both groups received four cycles of chemotherapy, two cycles during radiotherapy and two cycles after radiotherapy, respectively. In TP group, the patients received intravenous infusion of paclitaxel (135 mg/m2 ) on day 1 and cisplatin (25 mg/m2 ) on days 1-3, with every 28 days as one cycle. PF regimen consisted of cisplatin (25 mg/m2 ) on days 1-3 and continuous intravenous infusion of fluorouracil (500 mg/m2 ) on days 1-5, with every 28 days as one cycle. The short-term effects and adverse effects were observed after therapy, and median survival time was observed during the 5-year follow-up. Results There was a signif-icant difference of short-term efficacy between the two groups (P<0. 05). The adverse effects including radiation induced lar-yngitis, gastrointestinal reactions and myelosuppression showed significant differences between the two groups (P<0. 05). The median survival time was 2. 4 year in TP group and was 2. 0 years in PF group (P>0. 05). Conclusion TP regimen with concurrent radiotherapy has a high effective rate and better patient tolerance in the treatment of locoregionally advanced la-ryngeal cancer.
