CAJ | 학술논문

目的：探讨TPF方案诱导化疗加顺铂(DDP)每周或3周方案同期放化疗治疗局部晚期鼻咽癌的近期疗效。方法105例局部晚期（Ⅲ、Ⅳa期）鼻咽癌患者入组，随机分为诱导化疗加DDP3周方案A组，诱导化疗加DDP每周方案B组。两组均先行3程诱导化疗，方案为TAX75mg/m2第1d，5FU2.6g/m2泵入120h，顺铂75mg/m2第2d，每3周为1疗程。第10周开始放疗，放疗第1d同时行化疗。 A组：DDP80mg/m2，每3周1次。 B组：DDP40mg/m2，每周1次。放疗采用适形调强照射， GTVnx69-72Gy，30-34次，GTVnd66Gy-68.1Gy，30次。结果诱导化疗后A组同期化疗平均顺铂剂量为152.6mg，B组为132.5mg。 A组完全缓解率74.07%，部分缓解率25.93%；B组完全缓解率66.67%，部分缓解率33.33%。副反应两组在胃肠道反应，皮肤反应及骨髓抑制，体重下降无统计学意义，粘膜反应A组较B组轻P=0.01，有统计学意义。结论 TPF诱导化疗加DDP同期放化疗治疗局部晚期鼻咽癌推荐使用同期化疗3周方案。其远期毒副反应及疗效有无差异须进一步随访。
목적：탐토TPF방안유도화료가순박(DDP)매주혹3주방안동기방화료치료국부만기비인암적근기료효。방법105례국부만기（Ⅲ、Ⅳa기）비인암환자입조，수궤분위유도화료가DDP3주방안A조，유도화료가DDP매주방안B조。량조균선행3정유도화료，방안위TAX75mg/m2제1d，5FU2.6g/m2빙입120h，순박75mg/m2제2d，매3주위1료정。제10주개시방료，방료제1d동시행화료。 A조：DDP80mg/m2，매3주1차。 B조：DDP40mg/m2，매주1차。방료채용괄형조강조사， GTVnx69-72Gy，30-34차，GTVnd66Gy-68.1Gy，30차。결과유도화료후A조동기화료평균순박제량위152.6mg，B조위132.5mg。 A조완전완해솔74.07%，부분완해솔25.93%；B조완전완해솔66.67%，부분완해솔33.33%。부반응량조재위장도반응，피부반응급골수억제，체중하강무통계학의의，점막반응A조교B조경P=0.01，유통계학의의。결론 TPF유도화료가DDP동기방화료치료국부만기비인암추천사용동기화료3주방안。기원기독부반응급료효유무차이수진일보수방。
Objective To discuss the recent curative effect of TPF induction chemotherapy and cisplatin combined with every week or three weeks concurrent chemoradiotherapy. Methods 105 patients with the preliminary diagnosed locally advanced na-sopharyngeal carcinoma were included. These patients were randomly divided into two groups:group A:the patients treated with Induction chemotherapy and DDP for 3 weeks,group B:the patients treated with Induction chemotherapy and DDP every week. The two groups were given 3 courses induction chemotherapy firstly. The scheme was as follow:the first day:TAX75mg/m2,the second day:5FU 2.6g/m2 for 12h,cisplatin 75mg/m2,every 3weeks one course. Radiotherapy was given at tenth week,at the same time chemotherapy started:Group A:DDP80mg/m2,one time every 3 weeks. Group B:DDP 40mg/m2,one time every one week. In-tensity modulated radiation was used:,GTVnx69-72Gy/30-34fx,GTVnd66Gy-68.1Gy/30fx. Results After induction chemothera-py,the average dose of cisplatin in group A was 152.6mg,132.5mg in group B. In group A the complete remission rate was 74. 07%,the part remission rate was 25.93%. In group B,the complete remission rate was 66.67%,the part remission rate 33.33%. The side effects just like gastrointestinal reaction,skin reaction and bone marrow suppression had no statistical significance be-tween the two groups. Weight loss had statistical significance. The degree of mucosa reaction in group B was more serious than that in group A (P=0.01). Conclusion 3 weeks scheme of TPF induction chemotherapy combined with DDP concurrent chemora-diotherapy is recommended to treat on locally advanced nasopharyngeal carcinoma.