CAJ | 학술논문

目的比较紫杉醇脂质体联合奈达铂(TN)方案诱导化疗加奈达铂同期放化疗与传统氟尿嘧啶联合顺铂(PF)方案化疗治疗局部晚期鼻咽癌的近期疗效及耐受性.方法 56例初诊局部晚期(UICC分期Ⅲ、Ⅳ期)鼻咽癌患者入组,随机分为TN方案诱导化疗加奈达铂同期放化疗组(A组,28例),PF方案诱导化疗加顺铂同期放化疗方案组(B组,28例).诱导化疗每3周重复,共2个周期,第7周开始同步放化疗.结果 A组诱导化疗后鼻咽肿瘤消退有效率为78.6％,B组为75.0％ (P＞0.05)；A组颈部淋巴结消退有效率为82.1％,B组为75.0％(P＞0.05)；A组同步放化疗后鼻咽肿瘤消退有效率为96.4％,B组为85.7％ (P ＞0.05)；A组颈部淋巴结消退有效率为96.4％,B组为85.7％ (P ＞0.05).毒副反应方面,Ⅱ度以上的口腔黏膜炎发生率和胃肠道不良反应发生率A组明显低于B组,两组间比较差异有统计学意义(P＜0.05).结论紫杉醇脂质体联合奈达铂方案诱导化疗加奈达铂同期放化疗是治疗晚期鼻咽癌的有效可行方案,近期疗效好,不良反应较传统方案明显减少,耐受性好.
목적 비교자삼순지질체연합내체박(TN)방안유도화료가내체박동기방화료여전통불뇨밀정연합순박(PF)방안화료치료국부만기비인암적근기료효급내수성.방법 56례초진국부만기(UICC분기Ⅲ、Ⅳ기)비인암환자입조,수궤분위TN방안유도화료가내체박동기방화료조(A조,28례),PF방안유도화료가순박동기방화료방안조(B조,28례).유도화료매3주중복,공2개주기,제7주개시동보방화료.결과 A조유도화료후비인종류소퇴유효솔위78.6％,B조위75.0％ (P＞0.05)；A조경부림파결소퇴유효솔위82.1％,B조위75.0％(P＞0.05)；A조동보방화료후비인종류소퇴유효솔위96.4％,B조위85.7％ (P ＞0.05)；A조경부림파결소퇴유효솔위96.4％,B조위85.7％ (P ＞0.05).독부반응방면,Ⅱ도이상적구강점막염발생솔화위장도불량반응발생솔A조명현저우B조,량조간비교차이유통계학의의(P＜0.05).결론 자삼순지질체연합내체박방안유도화료가내체박동기방화료시치료만기비인암적유효가행방안,근기료효호,불량반응교전통방안명현감소,내수성호.
Objective To compare the efficacy and safety of paclitaxel liposome combined with nedaplatin induction chemotherapy(TN regimen) associated concurrent radio-chemotherapy with FU combined Cisplatin (PF regimen) on patients with locally advanced nasopharyngeal carcinoma.Methods Fifty-six patients with locally advanced nasopharyngeal carcinoma were randomly divided into two groups to receive TN regimen concurrent chemoradiotherapy(group A,n =28) and PF regimen concurrent chemoradiotherapy (group B,n =28) respectively.Induction chemotherapy was repeated every 3 weeks,a total of 2 cycles.Concurrent chemoradiotherapy was performed in the 7th week.Results The response of primary tumor and toxicity were observed.After induction chemotherapy the nasopharyngeal tumors' effective rates of the group A and B were 78.6％ and 75.0％ respectively,and cervical lymph nodes subsided effective rates were 82.1％ and 75.0％ respectively.There was no statistical significant difference between the two groups(P ＞0.05).After concurrent chemoradiation the nasopharyngeal tumors' effective rates of the group A and group B were 96.4％ and 85.7％ respectively,and cervical lymph nodes subsided effective rates were 96.43％ and 85.71％ respectively.There was no statistical significant difference between the two groups (P ＞ 0.05).The rates of oral mucosa reactions above degree Ⅱ and gastrointestinal reactions in group A were significantly lower than those in group B.There was statistical significant difference between the two groups(P ＜0.05).Conclusions Paclitaxel liposome combined with nedaplatin induction chemotherapy followed concurrent radio-chemotherapy is an effective and tolerable regimen in the treatment of locally advanced nasopharyngeal carcinoma.Adverse reactions reduced compared to the traditional regimen significantly.