CAJ | 학술논문

目的：评价多西他赛联合顺铂和氟尿嘧啶方案（ DpF方案）诱导化疗局部晚期鼻咽癌的近期临床疗效和毒性反应。方法：对25例经病理学证实的Ⅲ、Ⅳa期初治鼻咽癌患者于第1天静脉滴注多西他赛75 mg·m-2和顺铂75 mg·m-2，氟尿嘧啶2.5 g·m-2持续静脉泵入120 h，每3周为1疗程，2疗程后行同期放化疗。同期化疗方案为顺铂40 mg·m-2每周一次。结果：25例患者中，诱导化疗后鼻咽原发灶CR 5例（20.0%）、pR 18例（72.0%）、SD 2例（8.0%），总有效率为92%；颈部转移灶CR 4例（16.0%）、pR 21例（84.0%），总有效率为100%。放化疗后CR 24例（96%）、pR 1例（4%）。毒性反应主要为骨髓抑制、口腔粘膜和胃肠道反应，Ⅲ~Ⅳ度粒细胞减少占56%，60%以上的患者出现了中度（Ⅱ、Ⅲ度）胃肠道反应，其它毒副反应少见。综合治疗完成后有1例患者出现颈部淋巴结残留，其余患者均达CR。结论：多西他赛、顺铂及5-氟尿嘧啶诱导化疗较pF方案提高了局部晚期鼻咽癌的近期疗效，而且不良反应可以接受。其近期有效率的提高是否能转化为远期疗效值得进一步研究。
목적：평개다서타새연합순박화불뇨밀정방안（ DpF방안）유도화료국부만기비인암적근기림상료효화독성반응。방법：대25례경병이학증실적Ⅲ、Ⅳa기초치비인암환자우제1천정맥적주다서타새75 mg·m-2화순박75 mg·m-2，불뇨밀정2.5 g·m-2지속정맥빙입120 h，매3주위1료정，2료정후행동기방화료。동기화료방안위순박40 mg·m-2매주일차。결과：25례환자중，유도화료후비인원발조CR 5례（20.0%）、pR 18례（72.0%）、SD 2례（8.0%），총유효솔위92%；경부전이조CR 4례（16.0%）、pR 21례（84.0%），총유효솔위100%。방화료후CR 24례（96%）、pR 1례（4%）。독성반응주요위골수억제、구강점막화위장도반응，Ⅲ~Ⅳ도립세포감소점56%，60%이상적환자출현료중도（Ⅱ、Ⅲ도）위장도반응，기타독부반응소견。종합치료완성후유1례환자출현경부림파결잔류，기여환자균체CR。결론：다서타새、순박급5-불뇨밀정유도화료교pF방안제고료국부만기비인암적근기료효，이차불량반응가이접수。기근기유효솔적제고시부능전화위원기료효치득진일보연구。
Objective:To evaluate the clinical effect and toxic reaction of docetaxel combined with cisplatin and fluoroura-cil for induction chemotherapy in the treatment of patients with locally advanced nasopharyngeal carcinoma. Methods:Twenty-five patients with locally advanced nasopharyngeal carcinoma diagnosed pathologically were injected docetaxel(75 mg·m-2 )and cisplatin( 75 mg · m-2 )on the first day they were enrolled in by intravenous dripping;fluorouracil (2. 5 g·m-2 )in 120 hours by continuous intravenous pumping for 2 courses with a course of 3 weeks. Concurrent chem-otherapy was received. Cisplatin(40 mg·m-2 )was injected once a week in the concurrent chemotherapy regimens. Re-sults:Of all the 25 patients,completed response(CR)of nasopharyngeal primary tumor was 5 cases(20. 0%),partial responses(pR)was 18 cases(72. 0%),stable disease(SD)was 2 cases(8. 0%),and overall response rate was 96. 0%;completed response(CR)of neck metastasis lymph node was 4 cases(16. 0%),partial responses(pR)was 21 cases(84. 0%),and overall response rate was 100. 0%. The main toxicity was myelosuppression and gastrointestinal re-actions,Ⅲ~Ⅳ leucopenia occurred in 56. 0% of all cases,and Ⅱ~Ⅲ gastrointestinal reactions occurred more than 60%,It was rare to have other side effects. After Comprehensive treatment,all the cases got to CR except one case with neck lymph node residues. Conclutions:Compared with pF regimen,The docetaxel combined with cisplatin and fluoroura-cil regimen increases short-term clinical effect of locally advanced nasopharyngeal carcinoma;the toxicity and side effects are well-tolerated. It is worthy of further clinical studies on whether its increased short-term effects could turn into long-term effects.