局部晚期鼻咽癌诱导化疗加同步放化疗与单纯同步放化疗的比较分析

目的 观察局部晚期鼻咽癌（NPC）顺铂加5-氟尿嘧啶（PF）诱导化疗后同步调强放疗（IMRT）与单纯顺铂同步IMRT的疗效和副反应. 方法 73例NPC随机分为A、B两组,A组37例,PF诱导化疗1周期,顺铂20 mg/m2,dl-5,5-Fu 500 mg/m2,d1-5,休息2周,然后顺铂同步IMRT,顺铂同步方法为40 mg/m2,每周1次,共6次;B组36例,单纯顺铂同步IMRT,顺铂40 mg/m2,每周1次,共6次,评价两种方案治疗开始后3月的近期疗效、1和2年总生存率（OS）、无疾病进展生存率（PFS）及副反应. 结果 A、B组近期有效率分别为97.3％和97.2％;A组1、2年OS和PFS分别为100％和94.6％,97.3％和86.5％;B组1、2年OS和PFS分别为100％和91.7％,100％和83.3％.两组近期疗效和1、2年生存率无统计学差异.A组血液学毒性较B组明显. 结论 PF诱导同步与单纯顺铂同步放疗方案的疗效相似,单纯顺铂同步方案的血液学毒性较低.

Comparative analysis of induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone for locally advanced nasopharyngeal carcinoma

Objective To evaluate the efficacy and toxicity of induction chemotherapy of cisplatin plus 5-fluorouracil（PF） followed by concurrent chemotherapy（CCRT） with cisplatin and intensity modulated radiotherapy（IMRT） versus CCRT with cisplatin alone and IMRT for locally advanced nasopharyngeal carcinoma（NPC）.Methods All 73 patients with NPC were assigned randomly into groups A and B.Patients in group A received one cycle induction chemotherapy with PF（DDP 20 mg/m2,day 1-5,5-Fu 500 mg/m2,day 1-5） followed by CCRT with weekly cisplatin（40 mg/m2） for 6 weeks.Patients in group B were treated by IMRT with weekly concurrent cisplatin （40 mg/m2） for 6 weeks.Short-term efficacy,1-,2-year overall survival rates （OS） and progression-free survival rates （PFS） and side-effects of the two regimens were investigated.Results The overall response rate in groups A and B were 97.3％ and 97.2％,respectively.The 1-,2-year OS and PFS in group A were 100％ and 94.6％,97.3％ and 86.5％,respectively.In group B,the 1-,2-year OS and PFS were 100％ and 91.7％,100％ and 83.3％,respectively.No significant difference in short-term efficacy was found between two groups,but hematological toxicity was more obvious in group A.Conclusion The efficacy of the two regimens is similar.The regimen of CCRT with cisplatin alone and IMRT result in less hematological toxicity.