摘要
目的:观察同期放化疗加巩固化疗治疗Ⅲ～Ⅳa期鼻咽癌的临床疗效及其毒副反应。方法:2010年1月至2011年6月对48例Ⅲ～Ⅳa期鼻咽癌采取同期放化疗加巩固化疗。同期放疗采用常规连续分割放疗,鼻咽部DT70～78Gy/7～8周,颈部DT60～70Gy/6～7周;化疗分为:吉西他滨组:吉西他滨350mg/m2于放疗期间第1、8、15、29、36、43天静脉注射,放疗结束后改为吉西他滨1000mg/m2第1、8、15天,每4周重复,共两疗程;顺铂组:顺铂80mg/m2于放疗期间的第1、22、43天静脉注射,放疗结束后改为顺铂80mg/m2第1天、氟尿嘧啶800mg/m2d第1～5天,每4周重复,共两疗程。放疗后巩固化疗分别于第4、5、6周后进行并分为3组:4周后组、5周后组和6周后组。结果:48例患者中,吉西他滨组总有效率(CR+PR)为95.7%,顺铂组为92.0%,两者差异无统计学意义(P=0.602)。主要毒副作用是骨髓抑制、胃肠道反应和放射性口腔黏膜炎,其他毒副作用均较轻,可耐受。结论:使用低剂量吉西他滨同期放化疗,然后足量吉西他滨巩固化疗治疗Ⅲ～Ⅳa期鼻咽癌是一较好方案,毒副反应较轻。
Objective To observe the efficacy and toxicity of concurrent chemoradiotherapy plus adjuvant chemotherapy for nasopharyngeal carcinoma of stage Ⅲ and Ⅵa.Methods 48 patients with nasopharyngeal carcinoma of stage Ⅲ and Ⅳa were administered with concurrent chemoradiotherapy plus adjuvant chemotherapy.The prescribed radiation regimen was 70 ～ 78 Gy/7 ～ 8 week to nasopharynx,60 ～ 70 Gy/6 ～ 7 week to cervical metastatic focus.The patients were treated with gemcitabine（gemcitabine group） or cisplatin（cisplatin group）.Patients in gemcitabine group received concurrent gemcitabine（350 mg/m2 on day 1,8,15,29,36,43） during radiation therapy,followed by gemcitabine（1 000 mg/m2 on day 1,8,15） every 4 weeks for 2 cycles.And patients in cisplatin group received concurrent cisplatin（350 mg/m2 on day 1,22,43） during radiation therapy,followed by cisplatin（80 mg/m2 on day 1） and fluorouracil（800 mg/m2 on days 1 to 5） every 4 weeks for 2 cycles.The adjuvant chemotherapy was administered in the 4th,5th,or 6th week after radiation therapy.Results The total response rates in the gemcitabine and cisplatin groups were 95.7% and 92%（P = 0.602）.Toxicity was mainly shown as myelosuppression,gastrointestinal response,and oral mucositis,and other toxicity was relatively lighter.After symptomatic treatment,all the patients could tolerate these toxicities and finished the chemoradiotherapy.Conclusion Gemcitabine offers a satisfactory clinical activity and an acceptable safety profile in patients with nasopharyngeal carcinoma of stage Ⅲ and Ⅵa.
出处
《实用医学杂志》
CAS
北大核心
2012年第20期3367-3369,共3页
The Journal of Practical Medicine
基金
广东省医学科研基金立项资助课题(编号:A2010279)
关键词
鼻咽癌
放射治疗
化学治疗
Nasopharynx
Radiotherapy
Chemotherapy
