中药防治局部晚期鼻咽癌同步放化疗急性毒副反应的临床观察

目的 探讨中药防治局部晚期鼻咽癌病人同步放化疗所致的急性毒性反应的疗效.方法 80例局部晚期鼻咽癌病人随机分为两组,观察组40例(中药联合同步放化疗),对照组40例(同步放化疗).两组均采用调强放疗同步行顺铂周方案化疗.比较两组病人的近期治疗疗效及急性毒副反应.结果 两组病人均接受了95%以上根治性放疗,观察组中有2例病人出现放疗中断,占5.0%,显著低于对照组的22.5%(P<0.05).在化疗依从性上,观察组化疗完成率为80.0%显著高于对照组的55.0%(P<0.05).两组近期有效率均为100%,观察组完全缓解率为85.0%稍高于对照组的77.5%,但差异无统计学意义(P>0.05).在近期毒性反应方面,观察组Ⅲ~Ⅳ度口腔黏膜反应、皮肤反应、胃肠道反应、骨髓抑制发生率分别为12.5%、10.0%、7.5%和10.0%,均低于对照组的35.0%、32.5%、27.5%和30.0%.结论 中药可以明显减轻局部晚期鼻咽癌同步放化疗所致的急性毒副反应,提高病人的依从性.

Clinical observation on effect of Chinese herbal medicine in preventing and treating acute toxicity reaction of chemoradiation in patients with locally advanced nasopharyngeal carcinoma

Objective To explore the therapeutic effect of Chinese herbal medicine for prevention and treatment of acute toxicity reaction of concurrent chemoradiation in patients with locally advanced nasopharyngeal carcinoma.Methods 80 cases of locally advanced nasopharyngeal carcinoma were randomly divided into an observation group of 40 cases treated Chinese herbal medicine combined with concurrent chemoradiation and a control group of 40 cases with only concurrent chemoradiation.Two group received intensity modulated radiotherapy besides weekly cisplatin chemotherapy.Curative effects and acute toxicity reaction of the two groups were compared.Results All cases received over 95% of radical radiation dose.2 cases (5.0%) of observation group postponed the radiation,significantly lower than 22.5% in the control group(P<0.05).Of observation group,80.0% of patients could be treated according to the plan of chemotherapy,significantly higher than 40.48% in the in the control group(P<0.05).The overall response rats was 100.0% in the two groups.The complete response rat was 85.0% in the observation group,higher than 77.5% in the control group,but there was no significant differences.The Ⅲ~Ⅳrat of oral mucositis,dermatitia,gastrointestinal toxicity and bone marrow suppression were 12.5%,10.0%,7.5% and 10.0% in experiment group,significantly lower than 35.0%,32.5%,27.5% and 30.0% in the control group(P<0.05).Conclusions Chinese herbal medicine can relieve acute toxicity reaction of concurrent chemoradiation in patients with locally advanced nasopharyngeal carcinoma and improve patients compliance.