奈达铂每周方案同期适形放疗治疗局部晚期鼻咽癌的临床研究

目的：探讨周剂量奈达铂化疗同步适形放疗治疗局部晚期鼻咽癌的疗效及不良反应。方法：81例局部晚期鼻咽癌患者,随机分为奈达铂同期适形放疗组（CRT组）和单纯适形放疗组（RT组）。RT组患者仅行适形放疗,CRT组患者在适形放疗的基础上加用奈达铂。观察两组患者的近期疗效、远期疗效和不良反应。结果：鼻咽部肿块残存率：CRT组为12.2%（5/41）,RT组为20.0%（8/40）;颈部肿块残存率：CRT组为17.1%（7/41）,RT组为37.5%（15/40）,CRT组明显低于RT组（P〈0.05）;CRT组和RT组1、3年生存率分别为92.7%（38/41）、75.6%（31/41）和92.5%（37/40）、70.0%（28/40）（P〉0.05）。不良反应主要表现为白细胞减少和Ⅲ度口腔黏膜反应。结论：小剂量奈达铂每周化疗同步放疗可提高局部晚期鼻咽癌颈淋巴消除率,其不良反应可接受。

Nedaplatin weekly program synchronization conformalradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma

Objective：To investigate the therapeutic effects and side effects of weekly NDP chemotherapy combined with radiotherapy in treatment of partly advanced nasopharyngeal carcinoma（NPC）.Methods：Total of 81 partly advanced NPC patients were randomly divided into CRT group and RT group.The patients in RT group were only administrated by conformal radiation therapy（3D-CRT）;The patients in CRT group were treated by weekly NDP besides 3D-CRT.The nearly and long-term therapeutic effects,as well as side effects of patients in 2 groups were observed.Results：The survival rate of nasopharyngeal mass： CRT group was 12.2%（5 / 41）,RT group was20.0%（8 / 40）;Neck survival rate： CRT group was 17.1%（7 / 41）,RT group was 37.5 %（15/40）,CRT group was significantly lower than the RT group（P0.05）;CRT group and the RT group 1,3 year survival rates were 92.7%（38/41）,75.6%（31/41） and 92.5 %（37/40）,70.0%（28/40）respectively（P0.05）.Toxicity was mainly neutropenia and oral mucositis of grade Ⅲ.Conclusion：Low-dose nedapllatin weekly concurrent with radiatherapy in local advanced nasopharyngeal carcinoma can increase the cervical lymph eliminate rate and the toxicity was acceptable.