放疗联合吉西他滨加顺铂化疗序贯治疗中晚期鼻咽癌的临床研究

目的:评价吉西他滨+顺铂(DDP)联合放疗序贯治疗中晚期鼻咽癌疗效及其毒副反应。方法:首诊中晚期(Ⅲ、ⅣA)鼻咽癌患者240例,随机分为3组。实验组采用常规放疗联合GP化疗方案序贯治疗(GP+RT:GP化疗方案为吉西他滨800 mg/m2,d1,d8;DDP 20 mg/m2,d1~d3,每4周重复,共4个周期,并行常规放疗);对照1组采用同期放化疗(CT:放疗期间行化疗DDP 20 mg/m2,d1,每周1次,共6周;放疗结束后再行常规DDP+5-FU辅助化疗2个周期,即DDP 20 mg/m2,5-FU 500 mg/m2,d1~d5,每4周1个周期)。对照2组采用常规放疗联合PF化疗方案序贯治疗(PF+RT:5-FU 500 mg/m2,DDP 20 mg/m2,d1~d5,每4周1个周期,共4个周期)。评价3组病例近远期疗效及毒副反应。结果:经GP+RT序贯治疗后鼻咽及颈部病灶CR 98.8%(79/80),而同期放化疗组、PF+RT组分别为91.3%(73/80)、93.8%(75/80)。GP方案化疗的主要毒副反应为血小板及白细胞减少。所有病例随访均>3年。1、1~3及3年生存率、无瘤生存率和无远处转移率GP+CT组最高;PF+RT组次之;同期放化疗组较差。GP+DT组病例复发率及转移率则较其他2组低。结论:吉西他滨+顺铂化疗联合放疗序治疗中晚期鼻咽癌近远期疗效确切,值得临床一线应用。

Gemcitabine plus cisplatin sequently combining with radiotherapy for advanced nasopharyngeal carcinoma

OBJECTIVE:To evaluate the efficacy and toxicity of chemotherapy regimen of Gemcitabine plus Cisplatin sequently combining radiotherapy(GP+RT) for advanced nasopharyngeal carcinoma.METHODS: Totally 240 patients were enrolled in this study of chemo-radiotherapy and divided into 3 groups randomizedly.80 patients of experience group accepted regimens of GP chemotherapy sequently combining with regular radiotherapy(GP+RT): Gemcitabine 800 mg/m2,d1,d8;Cisplatin 20 mg/m2,d1-d5,every 4 weeks,4 cycles.Patients of co...