诱导加同步时辰化疗联合调强放射治疗鼻咽癌的前瞻性随机对照研究

目的 分析诱导化疗加同步时辰化疗与同步常规化疗联合调强放疗治疗局部晚期鼻咽癌的不良反应、淋巴免疫功能及疗效.方法 将60例局部晚期鼻咽癌患者采用信封法随机分组,试验组为诱导化疗加同步时辰化疗联合调强放疗,对照组为诱导化疗加同步常规化疗联合调强放疗.两组均采用2个周期多西他赛+顺铂+5-氟尿嘧啶诱导化疗,同步化疗均采用顺铂,试验组采用时辰给药方式,对照组采用常规静脉给药方式.观察两组的不良反应、淋巴免疫功能及疗效.结果 同步放化疗期间试验组恶心(Z=2.50,P＜0.05)、呕吐(Z=3.31,P＜0.05)较对照组轻.同步放化疗后试验组CD4 +/CD8+高于对照组(t=3.34,P＜0.05).两组诱导化疗加同步放化疗的疗效差异无统计学意义(P＞0.05).结论 在不降低疗效的情况下,时辰给药方式能减轻恶心、呕吐不良反应,改善免疫功能,有可能成为鼻咽癌一种更合理的治疗方式.

A prospective and randomized study of induction and concurrent chrono-chemotherapy combined with intensity modulated radiotherapy in nasopharyngeal carcinoma

Objective To evaluate the adverse reactions, immune function and clinical response of induction chemotherapy followed by concurrent chrono-chemotherapy or conventional chemotherapy with intensity modulated radiotherapy in locally advanced nasopharyngeal carcinoma. Methods Sixty patients with locally advanced nasopharyngeal carcinoma were randomly distributed into two groups. Experimental group was induction chemotherapy followed by concurrent chrono-chemotherapy with intensity modulated radiotherapy. Control group was induction chemotherapy followed by conventional chemotherapy with intensity modulated radiotherapy. Induction chemotherapy with docetaxel and cisplatin and 5-fluorouracil of 2 cycles was used in both two groups. Two groups concurrent chemotherapy with cisplatin in different ways. Experimental group was chrono-chemotherapy, and control group was conventional chemotherapy. Two groups evaluate the adverse reactions and immune function and clinical response. Results Nausea(Z=2.50, P<0.05) and vomiting(Z=3.31, P<0.05) in experimental group was lighter than those in control group during concurrence chemoradiotherapy. CD4+/CD8+(t=3.34, P<0.05) in experimental group was higher than control group after concurrence chemoradiotherapy. The curative effect of two groups was no statistically significant difference(P>0.05) after induction chemotherapy followed by concurrent chemoradiotherapy. Conclusions The concurrent chrono-chemotherapy can reduce adverse reactions of nausea and vomiting, and improve immune function without reducing the curative effect. It is possible to be a more reasonable treatment of nasopharyngeal carcinoma.