多西他赛同步放疗与DF方案同步放疗治疗晚期鼻咽癌的临床研究

【摘要】目的 探讨多西他赛（DOC）同步放疗与顺铂（DDP）联合氟尿嘧啶（5-FU）同步放疗治疗晚期鼻咽癌的近期疗效和毒副反应。方法 将66例晚期鼻咽癌患者分为DOC组和DF组，每组各33例。DOC组具体为：DOC 25mg／m2静滴，每周1次，共7次。DF组具体为：DDP 25mg／m2静滴，d1～d3；5-FU 550mg／m2静推，d1～d5，21天为1周期，共2个周期。放射治疗采用6MV X线和9MeV电子线（双颈分野）外照射，鼻咽靶区剂量68～72Gy／6.8～7.2周。根据实体瘤疗效评价标准RECIST 1. 1评价近期疗效并计算有效率（RR），同时采用NCI CTC 3.0标准评价毒副反应。结果 66例患者均可评价疗效。DOC组获CR 20例、PR 10例、SD 3例，RR为90.9％；DF组获CR 21例、PR 10例、SD 2例，RR为93.9％。两组RR的差异无统计学意义（P＞0.05）。两组主要毒副反应包括中性粒细胞减少、胃肠道反应、放射性皮炎及口腔黏膜炎。DF组中性粒细胞减少和口腔黏膜炎的发生率明显高于DOC组（P＜0.05）。结论 DOC同步放疗治疗晚期鼻咽癌的近期疗效好，且毒副作用小，可作为晚期鼻咽癌治疗的新选择。

Clinical observation of docetaxel and DF regimen in concurrent chemoradiotherapy for advanced nasopharyngeal carcinoma

Objective To observe the short-term clinical efficacy and toxicity of docetaxel（DOC） and cisplatinum plus 5-fluorouracil（DF） regiman in concurrent chemoradiotherapy for advanced nasopharyngeal carcinoma（NPC）.Methods Sixty-six patients with NPC were divided into DOC group and DF group with 33 patients in each group.Patients in DOC group were given DOC 25mg/m2 iv,once a week for 7 weeks.Thirty-three patients in DF group were given cisplatin（25 mg/m2 iv d1-d3） and 5-fluorouracil（550 mg/ m2 civ,d1-d5）.Every 3 weeks was a cycle with a total of 2 cycles.Radiotherapy was given in the two groups.Radiation therapy was applied with 6MV Ⅹ-ray and 9MeV electronic wire（double neck distinction） from external exposure,and nasopharyngeal target dose was 68-72Gy/6.8-7.2weeks.Results The efficacy could be evaluated in all patients.In DOC group,20 cases were of CR,10 of PR,3 of SD,and response rate（RR） was 90.9% ; in DF group,21 cases were in CR,10 in PR,2 in SD,and RR was 93.9%.The differences of RR in the two groups had no significance（P 〉0.05）.The main toxicities were neutropenia,oral mucositis,dermatitis and digestive reation.The occurrence rates of neutropenia and oral mucositis in DF group were higher than those in DOC group （P 〈0.05）.Conclusion DOC in concurrent chemoradiotherapy for advanced NPC was with good efficacy and less toxicities,which can be used as a new option for advanced NPC.