摘要
目的:观察顺铂与多西紫杉醇每周方案联合调强放疗同期治疗局部晚期鼻咽癌的临床疗效、不良反应。方法:2003年1月至2008年10月初治的局部晚期鼻咽癌患者63例,年龄13-72岁(中位年龄53岁),男39例,女24例,其中Ⅲ期42例、Ⅳa期21例。随机分为两组,顺铂加调强放疗组(DDP组)32例,多西紫杉醇加调强放疗组(DTX组)31例,DDP组为放疗期间每周用顺铂25mg/m2;DTX组为每周用多西紫杉醇25mg/m2。共用5-6次。调强放疗给鼻咽部肿瘤(PGTVnx)70.6-76.6Gy/(31-33)次、颈部肿大淋巴结(PGTVnd)61.6-70.6Gy/(28-33)次。治疗相关不良反应按国际常见不良反应标准第3版(CTCAEV3.0)分级。结果:DDP组中位随访时间46个月,DTX组44个月;DDP组出现III级血液不良反应为2例,无IV级血液毒性,DTX组出现III级血液不良反应3例,IV级1例,两组均未见粒细胞减少引起的发热及败血症,两组比较无显著性差异(P=0.511)。DDP组III度急性口腔粘膜反应为18例,无IV度反应;DTX组III度急性口腔粘膜反应为19例,IV度1例,两组比较无显著性差异(P=0.504)。两组3年的局部区域控制率、无远处转移率和总生存率分别为92.6%、81.3%、90.5%;93.1%、85.3%、91.8%;两组5年的局部区域控制率、无远处转移率和总生存率分别为85.7%、72.6%、86.6%;93.1%、80.7%、91.8%。两组3年、5年总生存率比较无显著性差异(P>0.05)。结论:顺铂与多西紫杉醇每周方案联合调强放疗同期治疗局部晚期鼻咽癌的临床疗效基本相似,不良反应多西紫杉醇组稍重,但无统计学意义。
Objective：To analyze the effect of different chemotherapy regimens for concurrent chemoradiotherapy on locally advanced nasopharyngeal carcinoma patients treated with intensity - modulated radiotherapy. Methods ： Between 2003 and 2008,63 patients with locally advanced nasopharyngeal carcinoma were treated in our department,42 patients were stage Ⅲ while 21 patients stage Ⅳa. They were divided into 2 groups, one was treated with intensity - modulated radiotherapy（IMRT） combined with cisplatin （DDP group）, 32 cases. The other was treated with IMRT combined with docetaxel（ DTX group） ,31 cases. For DDP group ,we delivered prescription dose of 25mg/m^2 percent week combined with IMRT. For DTX group, the same dose docetaxel percent week. For IMRT, the prescription dose engaged to the gross tumor volume of nasopharyngeal （GTVnx） was 70.6 -76.6Gy/31 -33f, to the positive neck lymph nodes（GTVnd） was 61.6 - 70.6Gy/28 - 33f. Kaplan - Meier method was used to calculate the local - regional progression - free rate, distant metastasis - free rate, and overall survival rate. Adverse events were graded according to Common Teminology Criteria for Adverse Events version 3.0 （CTCAE v3.0）. Results：The median followed -up was 46 months for DDP group ,44 months for DTX group. For DDP group, the 3 - and 5 -year estimated local- regional progression-free survival rates,distant metastases - free survival rates and overall survival rates was 92.6% ,81.3% , 90.5% and 85.7% ,72.6% ,86.6% ,respectively. For DTX group,they were 93.1% ,85.3% ,91.8% and 93.1%, 80.7% ,91.8% ,respectively. The difference between DDP group and DTX group in 3 - （P =0. 531 ） and 5 -year （ P = 0.062） overall survival rates did not show significant difference. There were 2 patients in DDP group who experienced grade 3 hematologic toxicity and 3 patients in DTX group. There were no grade 4 in DDP group and 1 patients in DTX group. For DDP group, 18 patients developed grade 3 mucositis and no patient had grade 4. For DXT group,
出处
《现代肿瘤医学》
CAS
2010年第1期57-60,共4页
Journal of Modern Oncology
关键词
鼻咽肿瘤
化学治疗
调强放射疗法
nasopharyngeal neoplasm
chemotherapy
intensity modulated radiation therapy
