摘要
背景与目的:以往多西紫杉醇(docetaxel)联合顺铂(cisplatin,DDP)(TP方案)治疗鼻咽癌的临床试验的样本量小,得出的结果不一。本研究比较TP方案诱导化疗后TP与DDP同期放化疗在局部晚期鼻咽癌治疗中的近期疗效、不良反应。方法:57例初治鼻咽癌患者随机分为两组:同期TP方案放化疗组(TP组)30例;同期DDP放化疗组(DDP组)27例。两组诱导化疗采用TP方案(Docetaxel 70mg/m2第11天,DDP 80mg/m2d1),每3周1次,共2周期。同期化疗(每3周1次,共2周期):TP组采用TP方案(Docetaxel 60mg/m2d1,DDP 80mg/m2d2);DDP组采用DDP 80mg/m2d1。照射野采用CT-Sim设计,常规分割放疗。结果:57例患者完成诱导化疗111周期;53例患者完成同期化疗103周期。诱导化疗终止4例,同期化疗终止3例。所有入组患者都完成放疗。诱导化疗不良反应主要为血液毒性,同期放化疗不良反应主要为血液毒性和口腔粘膜反应。TP组3～4度白细胞减少、3～4度中性粒细胞减少的发生率明显高于DDP组,差异有统计学意义(P<0.005)。同期放化疗中,TP组患者100%使用G-CSF,明显高于DDP组(72.0%),两组比较差异有统计学意义(P<0.005)。同期放化疗后鼻咽部病灶完全缓解率:TP组93.3%,DDP组96.3%;区域淋巴结完全缓解率:TP组92.9%,DDP组91.3%。两组肿瘤反应比较差异无统计学意义。结论:TP方案诱导化疗后,TP同期放化疗的肿瘤缓解率与DDP同期放化疗相似。TP同期放化疗的不良反应发生比DDP同期放化疗高,但在G-CSF支持下,患者能耐受。TP方案的远期疗效值得进一步临床探讨。
Background and Objective. Clinical trials on docetaxel plus cisplatin （DDP） （TP regimen） in treating nasopharyngeal carcinoma （NPC） are still uncertain due to limited samples. This study was to compare the short-term efficacy and toxicity of induction chemotherapy with TP regimen followed by concurrent chemoradiotherapy with TP regimen versus DDP in treating locally advanced NPC. Methods： Fifty-seven patients with stage T3-4N2-3M0 NPC diagnosed pathologically from December 2005 to December 2006 were randomized into TP group （30 patients） and DDP group （27 patients）. Both groups received TP regimen as induction chemotherapy with docetaxel （70 mg/m^2） on Day 1 and DDP （80 mg/m^2） on Day 2, repeating every 21 days for 2 cycles. For concurrent chemotherapy, TP group were administered docetaxel （60 mg/m^2） on Day 1 and DDP （80 mg/m^2） on Day 2; DDP group were administered DDP （80 mg/m^2） on Day 1. Both schedules were repeated every 21 days for 2 cycles. Linear accelerator was used as radioactive source. Irradiation field was designed with CT-simulation and conventional fractions. Results. The 57 patients received 111 cycles of induction chemotherapy, and 53 of them received 103 cycles of concurrent chemotherapy; four patients ceased induction chemotherapy and three ceased concurrent chemotherapy. All patients completed radiotherapy. The major toxicity of induction chemotherapy was hematologic toxicity; the main toxicities of concurrent chemoradiotherapy were hematologic toxicity and mucositis. The occurrence rates of Grade 3-4 leucopenia and Grade 3-4 neutropenia were significantly higher in TP group than in DDP groups （P 〈0.05）. In concurrent chemoradiotherapy, the application rate of granulocyte colony stimulating factor （G-CSF） was significantly higher in TP group than in DDP group （100% vs. 72.0%, P〈0.05）. After concurrent chemoradiotherapy, the complete remission （CR） rates of the nasopharynx and regional lymph nodes were 93.3% and 92.9% in TP group, a
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2009年第3期279-285,共7页
Chinese Journal of Cancer
基金
广东省科技计划项目(No.2006B36001009)~~
关键词
鼻咽肿瘤
放射疗法
诱导化疗
泰素帝
顺铂
疗效
对照研究
nasopharyngeal neoplasm, radiotherapy, induction chemotherapy, docetaxel, cisplatin, efficacy, comparative study
