肿瘤乏氧细胞增敏剂甘氨双唑钠在鼻咽癌局部复发治疗应用.docVIP

肿瘤乏氧细胞增敏剂甘氨双唑钠在鼻咽癌局部复发治疗应用[摘要] 目的 探讨肿瘤乏氧细胞增敏剂甘氨双唑钠在鼻咽癌局部复发治疗的应用价值。方法 60例鼻咽癌首程根治性放疗后局部复发患者随机分为对照组(单纯放疗)、试验组(放疗+甘氨双唑钠),比较两组疗效和放射性损伤程度。结果 试验组完全缓解率、部分缓解率、1年生存率和1年无瘤生存率均高于对照组,差异显著。两组患者在放射性损伤程度方面均无显著性差异。结论 甘氨双唑钠可增强鼻咽癌局部复发灶放射治疗敏感性,同时不增加放疗的毒副反应。 [关键词] 肿瘤乏氧细胞; 甘氨双唑钠; 鼻咽癌; 复发 [中图分类号] R739.62 [文献标识码] A [文章编号] 1673-9701(2009)23-15-03 Glycididazole Sodium Used as an Hypoxic Tumor Cell Radiosensitizer in the Treatment for Recurrence of Nasopharyngeal Carcinoma ZHOU Lu Shunde Hospital of Traditional Chinese and Western Medicine,Guangdong 528333,China [Abstract] ObjectiveTo study the effect of glycididazole sodium in the treatment for recurrence of nasopharyngeal carcinoma. MethodsSixty patients with recurrence of nasopharyngeal carcinoma were randomly divided into two groups,control group receiving radiotherapy and exprimental group receiving radiosensitizer. The clinical efficacy and radiation injury were compared in two groups. ResultsComplete remission rate,partial remission rate and one-year survival rate in the experimetnal group were significantly higher than those in control group.There was no significant difference in radiation injury between two groups. ConclusionGlycididazole sodium can be used as an hypoxic tumor cell radiosensitizer to improve the clinical efficacy of radiotherapy in the treatment for recurrence of nasopharyngeal carcinoma with no increase in the radiation injury. [Key Words]Hypoxic tumor cell; Glycididazole sodium; Nasopharyngeal carcinoma; Recurrence 鼻咽癌(Nasopharyngeal carcinoma,NPC)是我国常见的恶性肿瘤之一,年发病率为(10～25)/10万,而广东省的鼻咽癌患者占了国内的60%。放射治疗被公认为鼻咽癌首选治疗方法。在鼻咽癌的放疗中经常会遇到放疗后肿瘤复发、放射抗拒等问题,即使是经过及时、正规的根治性放射治疗或综合放化疗,也难免有部分患者出现鼻咽和(或)颈部淋巴结的复发。目前认为复发的最主要的原因是由于实体瘤中存在10%～50%的乏氧细胞,它们对射线具有抗拒作用。而甘氨双唑钠(Glycididazole Sodium,CMNa)是目前国内外唯一一个正式在临床上应用的高效低毒的放化疗增敏剂[2]。Ⅱ、Ⅲ临床试验研究表明,CMNa对头颈部肿瘤、食管癌和肺癌等都有显著的疗效,尤其能明显提高患者的完全缓解率;安全性好,对心、肾功能无明显损伤;不增加放疗的毒副反应。我科自2004年以来其应用于局部复发性鼻咽癌二次放疗,现对其疗效及副反应作一总结。 1 资料与方法 1.1 一般资料 纳入标准:病理确诊的鼻咽癌首程根治性放射治疗后局部复发患者;年龄在30～60岁