复方苦参联合同步放化疗治疗局部晚期鼻咽癌的临床研究

目的 比较复方苦参注射液联合同步放化疗与单纯同步放化疗治疗局部晚期鼻咽癌的的近期疗效和毒副作用.方法 将70例经病理学证实为局部晚期鼻咽癌（按92年福州分期Ⅲ、ⅣA期的初治鼻咽癌）患者随机分为治疗组即复方苦参组（复方苦参联合同步放化疗）和对照组（同步放化疗）各35例.两组同步放化疗均采用相同的常规分割根治性二维放疗和单药顺铂同步化疗（顺铂 20mg/m2,静脉应用,每周一次,共用5周）.复方苦参组中采用复方苦参注射液15 ml＋5%葡萄糖注射液250 ml,d1～d14.治疗期间每周观察口咽黏膜反应、面颈部皮肤反应、骨髓抑制等副反应.同步放化疗结束后2周后对患者进行体力状况评分.放疗后3个月,12个月评价有效率（CR＋PR）.结果 复方苦参组患者的体力状况评分（KPS评分）优于对照组.口咽黏膜反应、面颈部皮肤反应、骨髓抑制等不良反应在复方苦参组均较对照组轻（P〈0.05）.复方苦参组有效率高于对照组（85.71% vs 71.42%）,差别有统计学意义（P=0.0375）.结论 复方苦参注射液联合同步放化疗治疗局部晚期鼻咽癌能减轻同步放化疗的副反应,并提高有效率.

Clinical study on treatment of Fufangkushen combined with concurrent chemoradiotherapy in advanced nasopharyngeal cancer

Objective To study the efficacy of combining Fufangkushen injection treatment with concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods 70 patients with pathologically proved advanced nasopharyngeal carcinoma（92 in Fuzhou in stage Ⅲ, and Ⅳ A period of locally advanced nasopharyngeal carcinoma） were divided into treatment group and control group in random with 35 cases in each group. In treatment group, patients got the treatment of Fufangkushen combined with concurrent chemoradiotherapy simultaneously （Fufangkushen treatment group）, while in control group, patients were treated solely with concurrent chemoradiotherapy, both of the groups adopted a program of conventional radiation therapy and chemotherapy （cisplantin 20mg/m2 once weekly, over 5 weeks）. In Fufangkushen treat group, concurrent ehemoradiotherapy combined injection Fufangkushen 15ml ＋ 5% glucose injection 250ml, d1 -d14 Weekly observing the oropharyngeal reactions, skin reactions, side effects such as bone marrow suppression（leukopenia）. After concurrent chemoradiotherapy for two weeks, patients with functional status and immune function points were observated according to KPS.After radiotherapy for 6 and 12 months,disease remmision rate（CR＋PR）.Results In the short-term results itshowed that Fufangkushen treatment group responded better to control group. The performance status of Fufangkushen treatment group, according to KPS questionnaire,was higher than that of control group. As to the side effects of oral ulcers, throat pain associated with oropharyngeal dysphagia and other symptoms, and the skin reactions on the face and neck and leucopenia response, Fufangkushen treatment group suffered less than control group, which showed clear statistical significance（ P = 0. 00375）. Conclusion Fufangkushen injection combined with concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal cancer can enhance the effectiveness, reduce the clinical symptoms resulting from the treatment and improve immune function effectively, improve patients＇ physical wellbeing and promote the quality of life in locally advanced nasopharyngeal.