甘氨双唑钠联合PLF方案同期放化疗治疗局部晚期鼻咽癌的近期疗效观察

目的观察甘氨双唑钠联合顺铂加5-氟脲嘧啶/醛氢叶酸（PLF）方案同期放化疗对局部晚期鼻咽癌的近期疗效及毒副作用。方法 66例经病理确诊的Ⅲ～ⅣA期鼻咽癌患者,随机分成治疗组和对照组,治疗组31例,对照组35例。两组均采用6MV的X线加速器进行常规放疗,鼻咽原发灶DT70～72Gy/7周,颈转移灶DT64-66Gy/6.5～7周。每周照射5天,每天1次,周剂量10Gy。并予PLF方案同期化疗,其中治疗组同期配合甘氨双唑钠（CMNa）800mg/m^2放疗前1h静脉滴注,每周3次。结果在放疗剂量至60Gy时,治疗组的鼻咽肿瘤完全缓解率高于对照组（64.5%vs34.3%,P〈0.05）。放疗结束后3个月,治疗组鼻咽肿瘤完全缓解率87%也同样高于对照组的62.9%（P〈0.05）;急性毒副反应两组无明显差异（P〉0.05）。结论甘氨双唑钠联合PLF方案同期放化疗可以提高局部晚期鼻咽癌的肿瘤消退速度及消退率,近期疗效优于单纯化疗增敏,无明显的急性毒副作用,耐受性好,值得临床推广应用。

Short-term efficacy of concurrent chemoradiotherapy with sodium glycididazole plus cisplatin and fluorouracil/leucovorin for local advanced nasopharyngeal carcinoma

Objective To evaluate the short-term efficacy and toxicity of cisplatin and fluorouracil/leucovorin（PLF） plus sodium glycididazole in concurrent chemoradiotherapy for local advanced nasopharyngeal carcinoma（NPC）.Methods 76 patients with local advanced NPC （ Ⅲ ～ Ⅳ A） were randomized into chemoradiothempy with PLF schedule plus sodium glycididazole group （therapy group,n=31） and chemoradiotherapy with PLF schedule group （control group,n=35）.All the patients received radiotherapy with 6 MV linear accelerator and concurrent injection of cisplatin and fluorouracil/leucovorin at a weekly dose of 80mg/m^2,2.5g/m^2 and 0.2g/m^2 respectively in the first and fifth week during the radiotherapy.In therapy group,the patients received injections of sodium glycididazole at 800 mg/m^2 prior to the radiotherapy 3 times a week.Results At the radiotherapy dose to 60Gy,a complete response rate of 64.5% and 34.3% was achieved in therapy group and control group,respectively （P〈0.05）.3 months after therapy,the corresponding complete response rate was 87% and 62.9% in therapy group and control group,respectively （P〈0.05）;no significant differences of acute toxicitis occurred between the two group.Conclusion Sodium glycididazole plus cisplatin and fluorouracil/leucorovin can accelerate the tumor remission and improve the complete remission rate in patients with local advanced NPC without causing severe toxicity.