局部晚期鼻咽癌TP方案诱导化疗及同期放化疗初步观察

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【摘要】 目的：观察局部晚期鼻咽癌诱导化疗及不同化疗方案的依从性及不良反应。方法：将60例局部晚期鼻咽癌患者按照随机数字表法分为A、B、C三组，A组tp诱导化疗+同期顺铂放化疗，B组顺铂同期放化疗，C组TP同期放化疗。放疗为调强放疗，GTVnx 68～72 Gy，GTVnd 65～70 Gy。观察三组治疗依从性及不良反应情况。结果：三组完成化疗数比例分别为80.0%、95.0%、90.0%，放疗全部足量完成，依从性均好，最常见反应为胃肠道反应、口咽黏膜炎、骨髓抑制、皮肤损伤，三组比较差异均无统计学意义（P>0.05）。但同时中重度不良反应发生率A组最高，B组最低，差异有统计学意义（P

【关键词】 局部晚期鼻咽癌； 同期放化疗； 诱导化疗； 不良反应

Preliminary Research of TP-based Induction Chemotherapy and Concurrent Chemotherapy in the Treatment of Locally Advanced NPC/LI Jin-wei，XIAO Hai，WANG Rong，et al.//Medical Innovation of China，2016，13（27）：010-013

【Abstract】 Objective：To observe the adherence and adverse reactions of induction chemotherapy and different concurrent chemotherapy regimens for locally advanced nasopharyngeal carcinoma（NPC）.Method：A total of 60 patients with locally advanced NPC were randomly divided into A，B，C groups，20 cases in each group.Group A was given TP-based induction chemotherapy，followed by concurrent chemoradiotherapy with cisplatin；Group B was given Cisplatin-based concurrent chemoradiotherapy.Group C was given TP-based concurrent radiochemotherapy.Radiotherapy was used by IMRT，GTVnx 68-72 Gy，GTVnd 65-70 Gy.The treatment compliance and incidence of adverse reactions of three groups were observed.Result：Group A，B and C completed the expected number of chemotherapy rates were 80.0%，95.0%，90.0%.Radiotherapy were completed at sufficient amount，compliance was good，the most common were gastrointestinal，oropharyngeal mucositis，myelosuppression，skin damage.In severe injuries differences were no statistical difference（P>0.05）.But all adverse reactions rates were statistically different，group A was the highest，group B was the lowest，there was statistical significance（P

【Key words】 Locally advanced nasopharyngeal carcinoma； Concurrent chemoradiotherapy； Induction chemotherapy； Adverse reactions

First-author’s address：Ganzhou Tumor Hospital，Ganzhou 341000，China

doi：10.3969/j.issn.1674-4985.2016.27.003

调强放疗在剂量学和生物效应方面较常规放疗有绝对优势，显著提高局部控制率，是鼻咽癌治疗首选 [1-4]。INT0099试验确立了同期放化疗作为局部晚期鼻咽癌标准治疗[5]。诱导化疗取得较高局部缓解率，对生存率贡献结论不一，诱导化疗及同期化疗方案、与同期化疗的配合模式仍存在争议[6-10]。为此对2014年1-11月笔者医院60例局部晚期鼻咽癌，通过行与不行诱导化疗，及同期化疗的不同方案，记录不良反应发生率，观察依从性，现报告如下。