奈达铂与顺铂同期放化疗治疗局部区域晚期鼻咽癌毒副反应比较及护理

目的：对比分析奈达铂（nedaplatin，NDP）治疗方案和顺铂（cisplatin，DDP）治疗方案在同步放化疗治疗局部区域晚期鼻咽癌毒副反应，并总结护理要点。方法选择本科室2012年3月～2013年3月收治的局部区域晚期鼻咽癌患者112例，采.用区组随机的方法由电脑产生随机号，根据患者临床分期分层分为试验组（NDP＋放疗）56例，对照组（DDP＋放疗）56例。两组均采.用调强放射治疗，试验组为NDP 100 mg/m2静脉滴注；对照组为DDP 100 mg/m2静脉滴注，放疗期每3周1次（放疗第1天，第22天，第43天），共3个疗程。比较两组患者治疗效果及治疗期间毒副反应发生情况。结果治疗结束时试验组和对照组患者肿瘤完全缓解率分别为87.5％和85.7％（P＞0．05）。试验组患者胃肠道反应、口腔黏膜炎严重程度明显轻于对照组（均P＜0．05），血小板下降试验组明显高于对照组（P＜0．05），在白细胞下降、肝肾功能损害方面比较，差异无统计学意义（均P＞0．05）。结论 NDP联合放疗治疗局部区域晚期鼻咽癌相对DDP联合放疗的毒副反应少，患者易于接受，生活质量有所提高。在应.用两种化疗方案时，应关注患者毒副反应的发生情况，有所侧重地给予针对性的护理。

Adverse reactions of Nedaplatin and Cisplatin in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma

Objectives To analyze comparatively the adverse reactions of Nedaplatin（NDP）and Cisplatin（DDP）in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma and summarize the nursing points as well.Methods From March 2012 to March 2013,112 patients with locally advanced nasopharyngeal carcinoma were randomly divided into NDP group and DDP group.Besides intensity modulated radiotherapy for both groups,NDP group were treated with intravenous drop infusion of NDP by 100 mg/m2 and the control group with intravenous drop infusion of DDP by 100 mg/m2 both for three courses of once every three weeks （e.g.day one,day 22 and day 43 during the course）.The two groups were compared in terms of therapeutic effects and incidences of adverse reactions.Results The complete remission rates of the NDP group and DDP group were 87.5%and 85.7%,respectively （P＆gt;0.05）.The incidences of adverse reactions like gastrointestinal reactions and radioactive mucositis in the NDP group were significantly lower than those in the DDP group（P＆lt;0.05）and the index of platelet decrease was significantly higher（P＆lt;0.05）.There were no significant differences between the two groups in terms of liver and kidney dysfunction and white blood cells decrease（P＆gt;0.05）. Conclusions Chemotherapy with NDP combined with radiotherapy for locally advanced nasopharyngeal carcinoma has fewer adverse effects and is easy to be accepted by patients so that their quality of life can be improved.In the application of the two kinds of chemotherapy,we should pay attention to the adverse reactions on patients in order to give pertinent care.