中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
20期
3060-3064
,共5页
鼻咽肿瘤/化放疗法%放射疗法,适形调强%化学疗法,诱导%化学疗法,同期
鼻嚥腫瘤/化放療法%放射療法,適形調彊%化學療法,誘導%化學療法,同期
비인종류/화방요법%방사요법,괄형조강%화학요법,유도%화학요법,동기
Nasopharyngeal neoplasms/chemoradiotherapy%Radiotherapy,IMRT%Chemotherapy,induction%Chemotherapy,concurrent
目的:评价NP及FP方案诱导化疗+同步适形调强放疗治疗局部晚期鼻咽癌的毒副作用和疗效。方法经病理学或细胞学证实的局部晚期鼻咽癌患者81例,采用数字表法随机分为两组。观察组采用NP方案诱导化疗:长春瑞滨(NVB)25~30 mg/m2,第1、8天;顺铂(DDP)75 mg/m2,分为第1~3天。对照组:PF方案诱导化疗,DDP 75 mg/m2,分为第1~3天;氟尿嘧啶( Fu)750 mg/m2第1~5天,均每3周重复,化疗2~4周期,化疗结束后进行同步放化疗。观察组同步化疗:NVB 25~30 mg/m2,DDP 40 mg第1、8、22、29、43、51天,对照组同步化疗:Fu 750 mg/m2,DDP 25/m2第1、8、22、29、43、51天。同时给予同步鼻咽+颈部适形调强放疗。结果随访率为100%,观察组与对照组Ⅲ~Ⅳ度血液学毒性累计:白细胞减少47.5%与24.4%(χ2=4.73,P<0.05)。Ⅲ~Ⅳ度急性黏膜反应10%与20%。5年无局部区域复发生存率85.0%与65.9%(χ2=4.05,P<0.05)。5年总生存85.0%与68.3%(χ2=3.18,P<0.05)。结论 NP较FP方案诱导化疗+同步适形调强放疗治疗局部晚期鼻咽癌局部控制率高,5年无复发生存率高,毒副作用可耐受,远期毒性低。
目的:評價NP及FP方案誘導化療+同步適形調彊放療治療跼部晚期鼻嚥癌的毒副作用和療效。方法經病理學或細胞學證實的跼部晚期鼻嚥癌患者81例,採用數字錶法隨機分為兩組。觀察組採用NP方案誘導化療:長春瑞濱(NVB)25~30 mg/m2,第1、8天;順鉑(DDP)75 mg/m2,分為第1~3天。對照組:PF方案誘導化療,DDP 75 mg/m2,分為第1~3天;氟尿嘧啶( Fu)750 mg/m2第1~5天,均每3週重複,化療2~4週期,化療結束後進行同步放化療。觀察組同步化療:NVB 25~30 mg/m2,DDP 40 mg第1、8、22、29、43、51天,對照組同步化療:Fu 750 mg/m2,DDP 25/m2第1、8、22、29、43、51天。同時給予同步鼻嚥+頸部適形調彊放療。結果隨訪率為100%,觀察組與對照組Ⅲ~Ⅳ度血液學毒性纍計:白細胞減少47.5%與24.4%(χ2=4.73,P<0.05)。Ⅲ~Ⅳ度急性黏膜反應10%與20%。5年無跼部區域複髮生存率85.0%與65.9%(χ2=4.05,P<0.05)。5年總生存85.0%與68.3%(χ2=3.18,P<0.05)。結論 NP較FP方案誘導化療+同步適形調彊放療治療跼部晚期鼻嚥癌跼部控製率高,5年無複髮生存率高,毒副作用可耐受,遠期毒性低。
목적:평개NP급FP방안유도화료+동보괄형조강방료치료국부만기비인암적독부작용화료효。방법경병이학혹세포학증실적국부만기비인암환자81례,채용수자표법수궤분위량조。관찰조채용NP방안유도화료:장춘서빈(NVB)25~30 mg/m2,제1、8천;순박(DDP)75 mg/m2,분위제1~3천。대조조:PF방안유도화료,DDP 75 mg/m2,분위제1~3천;불뇨밀정( Fu)750 mg/m2제1~5천,균매3주중복,화료2~4주기,화료결속후진행동보방화료。관찰조동보화료:NVB 25~30 mg/m2,DDP 40 mg제1、8、22、29、43、51천,대조조동보화료:Fu 750 mg/m2,DDP 25/m2제1、8、22、29、43、51천。동시급여동보비인+경부괄형조강방료。결과수방솔위100%,관찰조여대조조Ⅲ~Ⅳ도혈액학독성루계:백세포감소47.5%여24.4%(χ2=4.73,P<0.05)。Ⅲ~Ⅳ도급성점막반응10%여20%。5년무국부구역복발생존솔85.0%여65.9%(χ2=4.05,P<0.05)。5년총생존85.0%여68.3%(χ2=3.18,P<0.05)。결론 NP교FP방안유도화료+동보괄형조강방료치료국부만기비인암국부공제솔고,5년무복발생존솔고,독부작용가내수,원기독성저。
Objective To investigate the efficacy and side effect of induction chemotherapy plus concurrent chemoradiotherapy ( IMRT) in the treatment of 81 patients with locally advanced nasopharyngeal carcinoma ( NPC) . Methods 81 patients with locally advanced NPC were divided into the vinorelbine group and fluorouracil group . Patients in the vinorelbine group were given vinorelbine 25-30mg/m2 d1,d8,DDP 75mg/m2 ,d1-d3.Patients in the fluorouracil group were given DDP 75mg/m2,d1-d3,fluorouracil 750 mg/m2 d1-d5.The treatment schedules were recycled every 3 weeks.After 2-4 cycles, the patients received concurrent chemoradiotherapy .In the vinorelbine group,IMRT with NVB 25-30mg/m2,DDP 40mg d1,d8,d22,d29,d43,d51 from the first day of IMRT.In the fluorou-racil group,IMRT with fluorouracil 750mg/m2 ,DDP 25/m2 d1,d8,d22,d29,d43,d51 from the first day of IMRT. Results The overall leukopenia and thrombocytopenia decline was 47.5% vs 24.4% in patients with Ⅲ and Ⅳgrade(χ2 =4.73,P<0.05).5-year locoregional relapse-free survival rates were 85.0% vs 65.9%(χ2 =4.05,P<0.05).5-year overall survival rates were 85.0%vs 68.3%(χ2 =3.18,P<0.05).Conclusion NP regiment induc-tion chemotherapy plus concurrent chemoradiotherapy for advanced NPC can achieve better result in clinical response and 5-year locoregional relapse-free survival rate compared with FP and the effect is clinically acceptable .