沙利度胺联合同步放化疗治疗局部晚期鼻咽癌临床观察

摘要

Objective To explore the clinical curative effect and adverse reactions of thalidomide combined with concur-rent chemoradiotherapy in treating local advanced nasopharyngeal carcinoma. Methods Sixty cases of local advanced nasopha-ryngeal carcinoma in the Mianyang Municipal Third People′s Hospital from January 2015 to January 2016 were selected and ran-domly divided into the observation group and control group according to the random number table method ,30 cases in each group. The observation group adopted thalidomide plus concurrent chemoradiotherapy (radiation total dosage 56-74 Gy,chemotherapeutic regimen was paclitaxel plus cisplatin;oral thalidomide at a dose of 100 mg/d,taking before sleep,once daily at the first week;be-ginning to increase to 200 mg/d from the second week ,then with 200 mg/d as the maintaining dose until the end of radiation thera-py),while the control group received the concurrent chemoradiotherapy. Results The effective rate and disease control group rate had no statistical difference between the two groups (P>0.05). The improvement rate of functional status in the observation group was significantly higher than that in the control group ,while the occurrence rate of nausea and vomiting was significantly lower than that in the control group and the occurrence rate of fatigue ,somnolence and constipation was significant higher than that in the control group ,the differences were statistically significant (P<0.05). Conclusion Thalidomide combined with concurrent chemoradiotherapy can improve the life quality of the patients with local advanced nasopharyngeal carcinoma ,increases the com-pliance to chemoradiotherapy,may have the potential to increase the long term survival rate,and is worth further study.%目的探讨沙利度胺（反应停、酞胺哌啶酮）联合同步放化疗治疗局部晚期鼻咽癌的临床疗效和不良反应。方法选取四川省绵阳市第三人民医院2015年1月至2016年1月收治的局部晚期鼻咽癌患者60例，采用随机数字表法分为观察组和对照组，每组30例。观察组采用沙利度胺联合同步放化疗（放疗总剂量为56～74 Gy，化疗方案为紫杉醇联合顺铂；沙利度胺第1周100 mg/d，晚上睡前顿服，每天1次；第2周开始增加至200 mg/d，以200 mg/d为维持剂量，口服至放疗结束）。对照组仅接受同步放化疗。结果两组有效率、疾病控制率比较，差异均无统计学意义（P>0.05）。观察组功能状态改善率明显高于对照组，恶心、呕吐发生率明显低于对照组，疲乏、嗜睡、便秘发生率明显高于对照组，差异均有统计学意义（P<0.05）。结论沙利度胺联合同步放化疗治疗局部晚期鼻咽癌可改善患者生活质量，提高对放化疗的顺应性，有提高远期生存率的可能，值得进一步研究。