每周奥沙利铂或顺铂同期放化疗治疗局部晚期鼻咽癌的随机对照研究

目的研究奥沙利铂或顺铂与放疗同步进行治疗局部晚期鼻咽癌的临床疗效和毒副反应。方法76例局部晚期鼻咽癌随机分成2组：奥沙利铂治疗组39例，顺铂对照组37例。2组均接受常规放射治疗。化疗方案：奥沙利铂治疗组70mg／m^2，顺铂对照组30mg／m^2，均为每周静滴1次。结果奥沙利铂治疗组和顺铂对照组鼻咽肿瘤及颈部淋巴结完全消退率无显著性差异（P〉0．05）。中位随访24个月后，2年无转移生存率奥沙利铂组为89．74％，顺铂组为91．89％；2年无复发生存率奥沙利铂组为92．31％，顺铂组为94．59％；无转移生存率及无复发生存率以顺铂组稍高，但与奥沙利铂组相比差异无显著性（P〉0．05）。Ⅲ、Ⅳ级恶心呕吐发生率以顺铂组显著（P〈0．05）；外周神经毒性以奥沙利铂组显著（P〈0．05），但均为Ⅰ、Ⅱ级。其余毒副反应以顺铂组稍高，但无统计学意义（P〉0．05）。结论奥沙利铂同步放化疗治疗局部晚期鼻咽癌疗效与顺铂相似，奥沙利铂胃肠道反应发生率低，患者更易耐受。

A randomized clinical control study on weekly concurrent chemoradiotherapy with oxaliplatin or cisplatin in the treatment of loco-regional advanced nasopharyngeal carcinoma

Objective To investigate the clinical efficacy and adverse reactions of concurrent chemoradiotherapy with oxaliplatin or eisplatin in the treatment of loco - regional advanced nasopharyngeal carcinoma （NPC）. Methods From Mar. 2003 to Feb. 2006, 76 patients with loco - regional advanced NPC were randomized into the oxaliplatin group （treatment group, 39 patients） and the cisplatin group （control group, 37 patients）. Routine radiotherapy was administered in both groups. Chemo - regimen： weekly intravenous dripping of oxaliplatin 70 mg/m^2 and cisplatin 30 mg/mg^2 was respectively given in the treatment group and the control group; radiotherapy regimen： a dosage of 70 -74 Gy for the loci of nasopharyngeal carcinoma, a dosage of 60 - 68 Gy for the cervical lymphatic nodes and a prophylactic dose of 50 Gy for the neck. Results There was no significant difference in the complete response rate of the nasopharyngeal and cervical nodal metastasis between the two groups （ P 〉 0.05 ）. After a median follow - up of 24 months, the 2 - year metastasis - free survival （MFS） rate was 89.74% for the oxaliplatin group versus 91.89% for the cisplatin group （ P 〉 0. 05 ）. The 2 - year relapse - free survival （RFS） rate was 92.31% for the oxaliplatin group versus 94.59% for the eisplatin group （P 〉 0.05 ）. The incidences of nausea and vomiting of grade Ⅲ/Ⅳ were significantly higher in the cisplatin group than in the oxgliplatin group （ P 〉 0.05）. Peripheral neuro - toxicity （ grade Ⅰ or Ⅱ ） was more evident in the oxgliplatin group than in cisplatin group （P 〉 0.05 ）. The incidence of other-adverse reactions in the cisplatin group were slightly higher than in the oxaliplatin group but the differences had no statistical significance （ P 〉 0.05 ）. Conclusion Oxaliplatin is similar to cisplatin in the treatment of concurrent chemoradiotherapy （ P 〉 0.05 ）, while oxaliplatin has lower incidence of adverse reactions in the gastrointestinal tract and is hence bet