奈达铂、卡铂联合氟尿嘧啶同期放化疗对中晚期鼻咽癌患者近远期治疗效果的评价

摘要

目的：观察奈达铂、卡铂两种第二代铂类化疗药物联合氟尿嘧啶同期放化疗对中晚期鼻咽癌患者近远期治疗效果。方法：根据AJCC第7版鼻咽癌2002UICC分期标准，选择广西壮族自治区人民医院耳鼻咽喉头颈肿瘤科收治的中晚期鼻咽癌病情控制良好的患者56例作为研究对象，采用随机分配原则将患者分为两组，观察组28例采用根治性放疗加以奈达铂联合氟尿嘧啶化疗，对照组28例采用根治性放疗加以卡铂联合氟尿嘧啶化疗，两组患者均接受2个周期的化疗，观察治疗期间的治疗效果和不良反应发生情况并在1年内进行病例随访，统计对比两组患者生存情况。结果：两组患者经过放化疗治疗后，观察组治疗有效率为92.9%，高于对照组75.0%；对照组不良反应发生率高于观察组，且不良反应首次发生时间快于观察组，比较差异有统计学意义（P<0.05）。两组患者随访1年，观察组死亡1例，21例无复发转移，6例复发转移肺骨；对照组死亡1例，16例无复发转移，5例肺及纵隔转移，6例肝脏及颈部淋巴结转移，两组远期治疗有效率比较，差异有统计学意义（χ2=2.146，P<0.05）。结论：奈达铂联合氟尿嘧啶同期放化疗对中晚期鼻咽癌患者近远期治疗效果均优于卡铂联合氟尿嘧啶，该治疗用药方案值得在临床上进行推广。%Objective:To observe Nedaplatin carboplatin two second-generation platinum-based chemotherapy combined with fluorouracil earlier discharge of patients with advanced nasopharyngeal carcinoma and long term effects of chemotherapy in the treatment.Method:According to the 7th edition AJCC staging nasopharyngeal 2002UICC choose Guangxi Zhuang Autonomous Region People’s Hospital,Department of Otolaryngology Head and Neck Oncology advanced nasopharyngeal carcinoma treated the disease in 56 patients with well-controlled as the research objects,using the principles of the patients were divided randomly assigned for the two groups,the observation group 28 cases to adopt radical radiotherapy combined with fluorouracil chemotherapy nedaplatin control group,28 cases using radical radiotherapy to carboplatin plus fluorouracil chemotherapy,patients received two cycles of chemotherapy and were observed during treatment therapeutic effects and adverse events and patients were followed up within a year,statistical comparison of the two groups patients survival.Result:After chemotherapy treatment,effective treatment of the observation group was 92.9%,which was higher than 75.0% of the control group;the total number of cases with adverse events of the observation group was more that that of the control group and time was faster.1 year later,1 patient died in the observation group,21 cases without recurrence,6 cases of recurrence;in the control group 1 case died,16 cases without recurrence,5 cases of lung and mediastinal metastasis,6 cases of liver and cervical lymph node metastasis,effective rate of the observation group was higher than that of the control group,difference was significant ( χ2=2.146,P<0.05). Conclusion:Nedaplatin plus fluorouracil concurrent chemoradiotherapy for advanced nasopharyngeal carcinoma and long term patient outcomes are superior to carboplatin plus fluorouracil,the treatment regimen worthy of promotion in clinical practice.