奈达铂单药联合放疗治疗鼻咽癌和食管癌的临床观察

目的　观察奈达铂单药联合同步放疗治疗鼻咽癌及食管癌的近期疗效及毒副反应。方法　选取３４例鼻咽癌和食管癌初治患者，采用奈达铂单药联合放疗，具体为：６ＭＶＸ线照射，ＤＴ６６～７０Ｇｙ／３３～３５ｆ，６～７ｗ完成，于放疗之日起给予奈达铂３０ｍｇ／ｍ^２，静脉滴注，每周１次，共６次。结果　３４例患者中，３３例可评价疗效，１例因过敏停药，鼻咽癌及食管癌的近期疗效分别为９０.０％和７６.９％。３３例可评价毒副反应，其中骨髓抑制２５例（７３.５％），３级白细胞减少３例（８.８％），３、４级血小板减少３例（８.８％）；消化道反应６例（１７.６％）；其中１３例食管癌患者中４例发生放射性食管炎，均可耐受。结论　奈达铂对放疗有增效作用，但骨髓抑制发生率较高；同时奈达铂周方案对患者的生活质量的影响相对较小，值得临床进一步观察。

Clinical observation of nedaplatin concurrent with radiotherapy for mid-advanced nasopharyngeal carcinoma and esophageal carcinoma

Objective To evaluate the short-term efficacy and the toxic reaction of nedaplatin concurrent with radiotherapy for mid-advanced nasopharyngeal carcinoma and esophageal carcinoma.Methods Thirty-four patients were confirmed diagnosis with cancer by pathologic results.All patients were given 6MV X-ray for radiotherapy,Dt 66-70Gy/33-35f/6-7w,concurrently administrated nedaplatin（30mg/m2） once a week（6 times）.Results A total of 34 patients were enrolled,of whom 33 patients were available for objective response,1 patients of esophageal cancer quit for allergic reaction.The response rate（RR） of nedaplatin-contained therapy for nasopharyngeal carcinoma and esophageal carcinoma were 90.0% and 76.9%,respectively.The major toxic reaction was bone marrow suppression observed in 25 patients（73.5%）,in which grade Ⅲ aleukocytosis was observed in 3 patients（8.8%）,grade Ⅲ＋Ⅳ thrombocytopenia in 3 patients（8.8%）,and 6 patients（17.6%） showed gastrointestinal tract reaction.There were 4 patients with radiation esophagitis in the 13 patients with esophageal carcinoma.Conclusion Nedaplatin can increase the therapeutic effect of radiation.Its incidence rate of bone marrow suppression is high,but the gastrointestinal tract reaction and renal toxicity is low and mild.