TP方案与PF方案化疗同步放疗对局部晚期喉癌的效果观察

目的观察紫杉醇加顺铂(TP)方案与顺铂加氟尿嘧啶(PF)方案化疗同步放疗对局部晚期喉癌的效果和毒性及不良反应。方法将局部晚期喉癌47例随机分为TP化疗同步放疗组(TP组)24例和PF化疗同步放疗组(PF组)23例。两组均予常规放疗,方法相同,原发灶及转移淋巴结放射耐受剂量(DT)60~70 Gy/6~7周(2.0 Gy/d,每周5次)。放疗同时予2周期化疗,放疗结束后继续完成2周期化疗,共4周期。TP组予紫杉醇135 mg/m2静脉滴注(第1天)、顺铂25 mg/m2静脉滴注(第1~3天),28 d为1个周期;PF组予顺铂25 mg/m2静脉滴注(第1~3天)、氟尿嘧啶500 mg/m2静脉注射(第1~5天),28 d为1个周期。治疗结束后观察近期疗效、毒性及不良反应发生情况,随访5年观察生存期。结果两组近期疗效比较差异有统计学意义(P0.05);TP组与PF组的放射性咽喉炎、胃肠道反应及骨髓抑制情况比较差异均有统计学意义(P0.05);中位生存时间TP组2.4年,PF组2.0年,差异无统计学意义(P0.05)。结论 TP方案化疗同步放疗治疗局部晚期喉癌有效率较高,患者耐受性良好。

Therapeutic Effects of Combined Cisplatin and Paclitaxel versus Cisplatin and Fluorouracil Regimen with Concurrent Radiotherapy for Locoregionally Advanced Laryngeal Cancer

Objective To explore the therapeutic effects and adverse effects of the two regimens：paclitaxel and cis-platin （ TP regimen） , cisplatin and fluorouracil （ PF regimen） , both with concurrent radiotherapy for the treatment of locore-gionally advanced laryngeal cancer. Methods Forty-seven patients with locoregionally advanced laryngeal cancer were ran-domly divided into the TP group （n=24） and the PF group （n=23）. All the patients received conventional radiotherapy at a total dose of 60-70 Gy in primary tumor and metastatic lymph nodes for 6-7 weeks （2. 0 Gy/d, 5 times per week）. Both groups received four cycles of chemotherapy, two cycles during radiotherapy and two cycles after radiotherapy, respectively. In TP group, the patients received intravenous infusion of paclitaxel （135 mg/m2 ） on day 1 and cisplatin （25 mg/m2 ） on days 1-3, with every 28 days as one cycle. PF regimen consisted of cisplatin （25 mg/m2 ） on days 1-3 and continuous intravenous infusion of fluorouracil （500 mg/m2 ） on days 1-5, with every 28 days as one cycle. The short-term effects and adverse effects were observed after therapy, and median survival time was observed during the 5-year follow-up. Results There was a signif-icant difference of short-term efficacy between the two groups （P〈0. 05）. The adverse effects including radiation induced lar-yngitis, gastrointestinal reactions and myelosuppression showed significant differences between the two groups （P〈0. 05）. The median survival time was 2. 4 year in TP group and was 2. 0 years in PF group （P〉0. 05）. Conclusion TP regimen with concurrent radiotherapy has a high effective rate and better patient tolerance in the treatment of locoregionally advanced la-ryngeal cancer.