DDP合并LV/5-FU不同应用方式治疗放疗前鼻咽癌的随机研究

目的 :比较DDP合并 2周大剂量LV/5 FU 4 8h连续输注与每月大剂量LV/5 FU 12 0h连续输注治疗鼻咽癌新辅助化疗的近期疗效与不良反应。方法 :通过前瞻性对照研究 ,将 4 6例中晚期鼻咽癌随机分成DDP合并 2周大剂量LV/5 FU 4 8h连续输注的治疗组 2 5例 ;DDP合并每月 5d大剂量LV/5 FU 12 0h连续输注的对照组的 2 1例 ,对其疗效及毒副反应进行观察、比较与分析 ,所有患者均接受 2个疗程的治疗。结果 :治疗组有效率 (CR PR) 92 0 % ,对照组有效率 81 0 % ,两者间差异无显著性 (P >0 0 5 ) ,3～ 4级毒性反应治疗组的患者比对照组的患者出现更多外周静脉炎 (32 0 %比2 3 8% ) ,其余出现更少白细胞减少 (40 0 %比 4 7 6 % ) ,黏膜炎 (8 0 %比 38 1% ) ,腹泻 (4 0 %比19 0 % ) ,恶心呕吐 (2 4 0 %比 38 1% ) ,但大多为Ⅰ～Ⅱ度。结论 :DDP合并 2周大剂量LV/5 FU 4 8h连续输注比每月 1次 5d大剂量LV/5 FU的方案更有效 ,毒性更低 ,值得进一步的前瞻性研究

A Prospectively Randomized Trial Comparing Clsplatln With Biweekly High-dose Leucovorin and 5-fluorouracll Continuous Infusion with Monthly High-dose Leucovorln and 5-fluorouracll Bolus in Neo-adJuvant Chemotherapy for Nasopharygeal Carcinoma

Objective To assess the anti-tumor efficacy and safety of neo-adjuvant chemotherapy of cisplatin with biweekly high-dose leucovorin and 5-fluorouracil 48-hour continuous infusion with monthly high-dose leucovorin and 5-fluorouracil 120-hour continuous infusion in the treatment of nasopharygeal carcinoma.Methods 46 patients of histologically proven advanced nasopharygeal carcinoma were prospectively randomized divided to treatment group and control group.Treatment group were treated with cisplatin with biweekly high-dose leucovorin and 5-fluorouracil 48-hour continuous infusion.Control group were treated with monthly high-dose leucovorin and 5-fluorouracil 120-hour continuous infusion.All enrolled patients were received two cycles treatment.Results The effective rates of these two groups showed no significante diffevence(treatment group 92.0%,control group 81.0%).The grade 3-4 peripheral phlebitis,bone marrow supperession,mucositis,diarrhea,nausea and vomiting were 32.0%,40.0%,8.0%,4.0%,24.0% in treatment group,respectively.while they were 23.8%,47.6%,38.1%,19.0%,38.1% in control group.Conclusion PFL regimen is an effective neoadjuvant chemotherapy for nasopharygeal carcinoma,but combined cisplatin with biweekly high-dose leucovorin and 5-fluorouracil 48-hour continuous infusion is more effective and lower toxicity procedure.Further studies are expected.