单药多西他赛联合放疗治疗局部晚期鼻咽癌的临床研究_临床医学论文.docVIP

单药多西他赛联合放疗治疗局部晚期鼻咽癌的临床研究_临床医学论文 单药多西他赛联合放疗治疗局部晚期鼻咽癌的临床研究_临床医学论文 【摘要】目的：观察多西他赛（国产艾素）单药联合放疗与顺铂（DDP）加5-氟尿嘧啶（5-FU）联合放疗治疗局部晚期鼻咽癌的比较。方法：47例局部晚期鼻咽癌患者随机分为治疗组24例，对照组23例，治疗组单药多西他赛35 mg/m2,1次/周，同期直线加速器放疗；对照组顺铂30 mg/m2,第1-3天，5-氟尿嘧啶500 mg/m2,第1-5天，同期直线加速器放疗。结果：近期疗效评价，鼻咽原发灶及颈部淋巴结（CR+PR）两组无差异（0.05）;一年内两组无疾病进展生存率（PFS）无差异（0.05）；两组毒副反应比较，治疗组恶心、呕吐及口腔黏膜反应明显低于对照组（0.05），但中性粒细胞减少发生率高于对照组（0.05）。结论：单药多西他赛治疗鼻咽癌，近期疗效相似，不良反应轻微，可耐受，是局部晚期鼻咽癌可选择的药物。 【关键词】多西他赛；鼻咽癌；放射治疗 ［Abstract］ objective: To evaluate the objective anti-tumor efficacy of docetaxel combined with radiotherapy versus cisplatin/5-fluorouracil(CF) regimen combined with radiotherapy on locally advanced nasopharyngeal carcinoma. METHODS: 47 cases of locally advanced nasopharyngeal carcinoma were randomized into docetaxel group (n=24) and CF group (n=23), patients in docetaxel group received docetaxel 35mg/m2 iv once a week during 7 or 8 weeks and received radiotherapy by linear accelerator simultaneously while patients in CF group received cisplatin 30mg/ m2 iv d1-3, 5-Fu 500 mg/ m2 iv d1-5 at the 1st and 5th week and the radiotherapy was performed as the docetaxel group. RERULTS: The change of primary cancer and metastasis of neck lymph nodes were no significant difference between two groups. There was also no significant difference in 1 year disease progress-free survival rate between two groups. The occurrence rates of nausea, vomiting and mucositis in docetaxel group was less than in CF group, while the occurrence rate of leucopenia was higher than in CF group. CONCLUSION: There is no difference in effects on local advanced nasopharyngeal carcinoma between docetaxel and PF regimen, and 1 year disease progress-free survival rates of them are compared, while the former have a better tolerance to be a suitable treatment for local advanced nasopharyngeal carcinoma. ［key words］Docetaxel; Nasopharyngeal carcinoma; radiotherapy 鼻咽癌是我国，尤其是南方最常见的肿瘤之一。经典的顺铂(DDP)联合5-氟尿嘧啶( 5-FU) ( PF) 方案是鼻咽癌患者的标准化疗方案, 但由于其毒性反应大, 在同期化疗中应用受到限制。我科于2003年8月至2007年1月采