多西紫杉醇联合顺铂( TP) 与顺铂联合 5 - FU( PF) 方案诱导化疗治疗局部晚期鼻咽癌疗效比较

目的：比较TP和PF方案诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的近期疗效及毒副反应.方法：60例Ⅲ-Ⅳa期鼻咽癌患者随机分为TP组和PF组,两组均行2周期诱导化疗,评价疗效、毒副反应.化疗结束后3周开始同期放化疗,放疗结束后3月评价近期疗效.结果：诱导化疗后,TP组CR率26.7%、PR率50.0%、有效率76.7%,PF组CR率10.0%、PR率40.0%、有效率50.0%,TP组有效率明显高于PF组（P＜0.05）.两组主要毒副反应均为血液学毒性及消化道反应,诱导化疗后TP组Ⅲ-Ⅳ度中性粒细胞减少的发生率明显高于PF组（P＜0.05）,但消化道反应明显低于PF组（P＜0.05）.结论：TP方案诱导化疗治疗局部晚期鼻咽癌近期疗效与PF方案相当,毒副反应可耐受,值得进一步观察其对长期生存的影响.

Comparison of efficacy of induction chemotherapy between docetaxel combined cisplatin（TP） and cisplatin combined 5-fluorouracil （TP） for locally advanced nasopharyngeal carcinoma

Objective：To observe the clinical efficacy and adverse reaction of TP and PF induction chelnotherapy followed by concurrent chelnoradiotherapy for locally advanced nasopharyngeal carcinolna. Methods： Sixty cases of stage Ⅲ-Ⅳ nasopharyngeal carcinolna were divided into TP group and PF group. Two groups were given 2 cycles induction chelnotherapy,the efficacy and adverse events of the two groups were colnpared. Then patients of two groups accepted concurrent chelnoradiotherapy,3 lnonths after chelnoradiotherapy to evaluate the short -terln effect. Results： After induction chelnotherapy, CR, PR were 26.7 % and 50.0 % respectively, and the overall response rate was 76.7% in TP group. CR, PR were 10.0% and 40.0% respectively, and the overall response rate was 50.0% in PF groups. There was significant difference in efficacy between the two groups （P 〈 0.05）. The main side effects were hemutologic toxicity and digestive system toxicity of two groups. After induction chemotherapy,the occurrence rates of grade Ⅲ-Ⅳ neutropenia were significantly higher in TP group than in PF group （P 〈 O. 05） , but the occurrence rates of digestive disorder were significantly lower in TP group than in PF group （P 〈0.05）. Conclusion：TP induc- tion chemotherapy treutnleut of local advanced nasophatTngeal carcinoma is similar to that of PF in short - term effects, and the adverse events are tolerable,the long- term outcomes need to be further investigated.