异环磷酰胺为主的联合方案治疗晚期复发鼻咽癌

[目的]观察比较异环磷酰胺(IFO)、顺铂(DDP)、5-氟尿嘧啶(5-Fu)联合方案(IPF方案)与DDP,5-Fu(PF方案)治疗晚期复发鼻咽癌(Ⅲ-Ⅳ期)的近期疗效及毒副反应。[方法]136例均经病理证实为晚期复发鼻咽癌患者,随机分为IPF组69例,PF组67例(对照组)[结果]IPF组和PF组有效率分别为69.56％(48/69)和43.3％(29/67),两组间差异有显著性(X2=8.519,P<0.01)。中位生存期:IPF组16个月(8-34个月),PF组为6.5个月(4-21个月),两组间差异有显著性(X2=22.36,P<0.05)。毒副作用主要为骨髓抑制,Ⅲ-Ⅳ度白细胞下降率IPF组为49.4％,PF组为5.97％,两组差异有显著性(X2=29.54,P<0.01)。Ⅲ-Ⅳ度血小板下降率IPF组为29.18％,PF组为0％(X2=30.29,P<0.01);Ⅲ-Ⅳ度消化道反应两组的发生率分别为15.94％和11.94％(x2=0.234,P>0.01).且以Ⅲ度为主。[结论]以IFO为主的方案联合治疗晚期复发鼻咽癌疗效好,毒副反应能耐受,可作为一线方案。

A Combined Chemotherapy Regimen Composed Mainly of Ifosfamide for the Treatment of Ad- vanced Recurrent Nasopharyngeal Carcinoma

[Objectives] To investigate and compare the recent efficacy and toxic side reaction of combined program using ifosfamide (IFO). cisplatin (DDP), 5-fluorouracil (5-Fu) (IFF regimen) and DDP, 5-Fu (PF regimen) in the treatment of advanced recurrent patients with nasopharyngeal carcinoma (NPC) III- IV stages, Methods One hundred and thirty-six patients of pathologically confirmed advanced recurrent NPC were randomly divided into two groups : 69 patients were treated with IPF regimen, while 67 patients treated with PF regimen served as control .Results The effective rates in IPF and PF groups were 69.56% (48/69) and 43.3% (29/ 67) respectively. There was statistically significant difference ( x - =8.519, P<0.01) between both groups. Median survival duration (MSD) of IPF and PF groups was 16 (8 - 34 )months and 6.5 (4-21) months, showing also significant difference ( x 2=22.36, P<0.05) between both. The major toxicity was bone marrow suppression. Grade I1I - IV leukocytopenia occurred in 49.4% of IPF group and 5.97% of PF group, with a significant difference between both ( x 2 =29.54, P <0.01). Grade III- IV platelet decreasing rates were 29.18% in IPF group and 0% in PF group ( x 2 =30.29, P<0.01). Grade HI- IV nausea and vomiting were observed in 15.94% of IPF and 11.94% of PF groups ( x z =0.234, P >0.01) and mainly occurred in grade II. Conclusions The toxic side reaction of combined therapy with regimen composed mainly of IFO can be well tolerated and its therapeutic efficacy is better in the treatment of patients with advanced recurrent NPC, so it can be used as a first line program of chemotherapy.