中晚期鼻咽癌放疗前大剂量顺铂及卡铂化疗颈淋巴结疗效对比分析

目的：比较二种铂类药物治疗鼻咽癌（ＮＰＣ）的临床疗效和毒副作用。方法：３４例有颈淋巴结转移的ＮＰＣ患者分两组（各１７例）进行放疗前化疗。两组化疗第１～５ｄ（ｄ１～５）均给以５－Ｆｕ１０００ｍｇ／ｍ２静滴（ｉｖｄｒｏｐ）外，第１ｄ（ｄ１）Ａ组卡铂（ＣＢＰ）３００ｍｇ／ｍ２ｉｖｄｒｏｐ；Ｂ组顺铂（ＤＤＰ）１００ｍｇ／ｍ２ｉｖｄｒｏｐ。结果：ＯＲ（ＣＲ＋ＰＲ）：Ａ组５２．９４％，Ｂ组６４．７１％，Ｐ＞０．０５，差异无显著性；两组ＷＢＣ值第３周最低，第４周回升，且Ａ组第２～３周ＷＢＣ均值比Ｂ组低，按ＷＨＯ毒性与分级标准ＷＢＣ降至Ⅲ－Ⅳ级Ａ组４７．０６％，Ｂ组１１．８２％，Ｐ＞０．０５，差异有显著性。结论：ＣＢＰ＋５－Ｆｕ与ＤＤＰ＋５－Ｆｕ治疗ＮＰＣ疗效相近，ＣＢＰ不需水化，可在门诊执行，两组ＷＢＣ均值都在第３周最低，第４周恢复，但ＣＢＰ对ＷＢＣ的影响要较ＤＤＰ严重

The Effect of the Neoadjuvant Chemotherapy on Middle and Advanced NPC by 5 Fu Plus DDP or CBP

Purpose: this paper presents a clinical trial to analyse and compare the effect of the neoadjuvant chemotherapy on middle and advanced NPC with lymphonodus metastases by DDP or CBP. Method: 34 NPC with lymphonodus metastases were diveded into two groups. Group A(17 patients) received CBP 300 mg/m 2 on day 1 plus 5 Fu 1 000 mg/m 2 on day 1￣5; Group B(17 patients) received DDP 100 mg/m 2 on day 1 plus the same amount of dose of 5 Fu. Results: OR(CP+PR) in group A was 52.94%, Group B 64.71%. No significant difference was found between the two groups( P >0.05). The mean values WBC count in both groups began to reduce at the second week, the lowest was at the third week, recovered at the fourth week. The percentage of WBC count reducing to grade 3 and 4 with WHO gd in group A was 47.06%, group B 11.82%. There was significant difference between the two groups ( P <0.05) . Conclusion: The effective of the neoadjuvant chemotherapy on NPC by CBP is close to DDP. CBP could be used in the outpatient department for the reason that it dosen’t need hydrotherapy. WBC counts of the two groups were the lowest at third week. WBC count is concerned. As for the effect on WBC count, CBP is more serious than DDP.