时辰化疗联合常规放疗对晚期复发转移NPC的疗效观察

目的 对比观察DDP联合5－FU的时辰化疗与常规化疗在同时期化、放疗应用过程中对晚期复发转移的鼻咽癌（nasopharyngeal carcinoma,NPC)的疗效。方法 局部晚期复发转移的NPC患50例,随机分为时辰化疗组（chrono－chemotherapy,CC)27例,常规化疗组（routine-chemotherapy,RC)23例,均采用同时期化、放疗措施。结果 CC组为27例,其CR率、有效率（CR＋PR）分别为8．7％,39．1％,中位生存期10mo(2.8-17mo)。两组CR率及有效率（CR＋PR）有显性差异（P＜0．05）,中位生存期无显性差异（P＞0．05）。毒副反应比较结果：RC组相对于CC组口腔炎、恶心、呕吐、脱发更多见（P＜0．05）,骨髓毒性反应亦有显性差异（P＜0．05）。结论 DDP联合5－FU的时辰化疗对晚期复发转移的NPC治疗效果较好,毒副反应较低,因此,同时期放疗与DDP联合5－FU的时辰化疗方案为晚期复发转移NPC较为有效的治疗方案。

Therapeutic effect of chrono-chemotherapy (DDP and 5-FU) with radiotherapy together for advanced or recurrent NPC

AIM While radiotherapy being taken, to compare the therapeutic effect of chrono chemotherapy (DDP and 5 FU) with routine chemotherapy on advanced or recurrentNPC. METHODS Fifty patients with advanced and recurrent NPC were divided randomly into 2 groups which included 27 cases in CC group (chrono chemotherapy); and 23 cases in RC group (routine chemotherapy). Both were treated with chemotherapy and radiotherapy together. RESULTS For CC group, CR rate and effective rate (ER) were 18.5%, 66.7% respectively, and median survival duration (MSD) was 12 mo (3~20 mo). For RC group, CR rate and ER were 8.7%, 39.1% respectively. MSD was 10 mo (2.8~17 mo). There was significant difference between the two groups in CR rate and ER ( P <0.05), but no significant difference in MSD ( P >0.05). There was a higher incidence of mucositis, nausea, vomiting, alopecia and bone marrow suppression in RC group than in CC group ( P <0.05). CONCLUSION Above data showed the Chrono Chemotherapy (DDP and 5 FU) may be favorable in the treatment of advanced and recurrent NPC, whose toxic and side reaction was weaker than RC groups', therefore, the chrono chemotherapy (DDP Combined 5 FU) appears to be more effective regimen for advanced and recurrent NPC than routine chemotherapy.