TPF方案诱导化疗联合同期放化疗治疗局部晚期鼻咽癌的临床研究

目的观察TPF方案诱导化疗联合同步放化疗治疗局部晚期鼻咽癌的疗效及不良反应。方法2009年1月至2010年1月，60例局部晚期鼻咽癌随机分为诱导化疗加同步放化疗（试验组，30例）和同步放化疗（对照组，30例）。两组放疗方法相同，均采用调强放射治疗（IMRT）。试验组TPF方案（多西他赛75mg／m^2，dl，顺铂75mg／m^2，dl，氟尿嘧啶500mg／m^2，d1-5q3W×2）诱导化疗＋同期放化疗（顺铂每周40mg／m^2加同步IMRT）。对照组同期放化疗（顺铂每周40mg／m^2加同步IM-RT）。结果试验组和对照组近期疗效比较差异无统计学意义（P〉0．05）。2年局部控制率试验组为96．6％，对照组为86．6％（P〉0．05）。2年无远处转移生存率试验组为93．3％（28／30），对照组为70．0％（21／30）（P〈0．05）。试验组Ⅲ／Ⅳ级白细胞及血小板下降明显高于对照组（P〈0．05）。结论诱导化疗加同步放化疗治疗局部晚期鼻咽癌疗效较好，且不良反应可耐受。

Study of TPF neoadjuvant chemotherapy followed by concurrent intensity modulated radiochemotherapy in the treatment for 30 cases with locally advanced nasopharyngeal carcinoma

Objective To investigate the short-term effect and toxicity of TPF neoadjuvant chemotherapy followed by concurrent intensity modulated radiotherapy(IMRT) and chemotherapy in the treatment for locally advanced nasopharyngeal carcinoma.Methods From January 2009 to January 2010,60 cases with locally advanced nasopharyngeal carcinoma were randomly divided into two groups.The test group(n=30) was received TPF neoadjuvant chemotherapy for 2 cycles.(TXT 75mg/ m2,d1,DDP 75mg/m2,d1,5-FU 500mg/m2,d1～5 q3w×2)followed by IMPT combined chemotherapy with DDP 40mg/m2/w.The Control group was received IMPT combined chemotherapy with DDP 40mg/m2/w.Results The short-term response in Experimental Group and in Control group was similar(P>0.05).The 2-years local control rate in Experimental Group and in Control group was 96.6%(29/30)and86.6%(26/30)respectively(P>0.05).The 2-years distant metastasis free survival rate in Experimental Group and in Control group was 93.3%(28/30) and 70.0%(21/30)respectively(P<0.05).The incidence of grade Ⅲ and Ⅳ leucocyte and platelet in Experimental Group was significantly higher than that in Control group(P<0.05).Conclusions TPF neoadjuvant chemotherapy followed by concurrent IMRT and chemotherapy for locally advanced nasopharyngeal carcinoma is effective and tolerable.