CAJ | 학술논문

目的比较不同剂量顺铂(DDP)同步适形调强放射治疗鼻咽癌患者的急性毒副反应和近期疗效差异.方法 88例接受适形调强放射治疗和单纯同期DDP化疗的Ⅱ～Ⅲ期初治鼻咽癌患者,采用随机数字表法随机分为标准组(DDP 100 mg/m2,每3周1次,44例)和研究组(DDP 80mg/m2,每3周1次,44例).比较完成治疗方案的两组患者在治疗期间的急性毒副反应和治疗后3个月的近期疗效.结果标准组同期放化疗过程中出现3～4级毒副反应32例(72.7％),研究组26例(59.1％),差异无统计学意义(P=0.18).标准组和对照患者出现的急性毒副反应中,仅上消化道反应和贫血的发生率差异有统计学意义(均P ＜0.05).放疗结束后3个月,全组患者鼻咽及颈部MRI检查达完全缓解(CR)者80例.标准组达CR者40例,肿瘤残留4例;研究组达CR者40例,肿瘤残留4例,差异无统计学意义(P=0.51).结论在适形调强放射治疗模式下,对于中国高发区Ⅱ～Ⅲ期初治鼻咽癌患者,采用单纯同期DDP 80 mg/m2,每3周1次治疗方案,出现3～4级急性毒副反应相对较轻,患者更易耐受.单纯同期DDP 80 mg/m2,每3周1次与DDP 100 mg/m2,每3周1次方案治疗的近期疗效相似.
목적 비교불동제량순박(DDP)동보괄형조강방사치료비인암환자적급성독부반응화근기료효차이.방법 88례접수괄형조강방사치료화단순동기DDP화료적Ⅱ～Ⅲ기초치비인암환자,채용수궤수자표법수궤분위표준조(DDP 100 mg/m2,매3주1차,44례)화연구조(DDP 80mg/m2,매3주1차,44례).비교완성치료방안적량조환자재치료기간적급성독부반응화치료후3개월적근기료효.결과 표준조동기방화료과정중출현3～4급독부반응32례(72.7％),연구조26례(59.1％),차이무통계학의의(P=0.18).표준조화대조환자출현적급성독부반응중,부상소화도반응화빈혈적발생솔차이유통계학의의(균P ＜0.05).방료결속후3개월,전조환자비인급경부MRI검사체완전완해(CR)자80례.표준조체CR자40례,종류잔류4례;연구조체CR자40례,종류잔류4례,차이무통계학의의(P=0.51).결론 재괄형조강방사치료모식하,대우중국고발구Ⅱ～Ⅲ기초치비인암환자,채용단순동기DDP 80 mg/m2,매3주1차치료방안,출현3～4급급성독부반응상대교경,환자경역내수.단순동기DDP 80 mg/m2,매3주1차여DDP 100 mg/m2,매3주1차방안치료적근기료효상사.
Objective To explore the acute toxic effects and early curative efficacy of concurrent chemotherapy with different doses of cisplatin for Chinese nasopharyngeal carcinoma (NPC) patients using intensity-modulated radiation therapy (IMRT).Methods Eighty-eight untreated stage Ⅱ/Ⅲ nasopharyngeal cancer patients receiving IMRT and concurrent cisplatin were randomized into two groups receiving different doses of cisplatin.The standard group (DDP 100 mg/m2 q3w,n =44) and the study group (DDP 80 mg/m2 q3w,n =44).The acute toxic effects and 3-month therapeutic efficacy (early curative efficacy) in patients of the two groups who completed treatment were compared and analyzed.Results During the treatment,grade Ⅲ-Ⅳ acute toxic effects were observed in more patients of the standard group compared with that in the study group (72.7％ vs.59.1％),but the difference was statistically not significant (P =0.18).Significant difference was only seen in upper gastrointestinal reaction (P =0.01) and anemia (P =0.03) among the non-hematological and hematological adverse events.No significant differences in other adverse events were found between the two groups (P ＜ 0.05).Three months after the completion of radiotherapy,80 cases of the whole group achieved complete remission(CR) in the nasopharynx and neck MRI.In both the standard group and study group,40 patients had CR and 4 patients had residual disease,respectively,showing a non-significant difference (P =0.51) between the two groups.Conclusions During the IMRT course,patients received cisplatin 80 mg/m2 q3w,experienced less grade Ⅲ-Ⅳ acute toxic effects.Concurrent chemoradiotherapy with cisplatin 80 mg/m2 q3w or 100 mg/m2 q3w,demonstrate similar early curative efficacy in Ⅱ/Ⅲ stage NPC patients in endemic regions of China.