奈达铂与顺铂单药周方案同步化疗治疗局部晚期鼻咽癌的疗效观察

摘要

目的：观察奈达铂（ NDP）和顺铂（ DDP）单药周方案同步化疗治疗初治局部鼻咽癌的毒副作用及近期疗效。方法初治局部晚期鼻咽癌患者60例，随机分成NDP组和DDP组，各30例。 NDP组化疗方案：0．9％氯化钠500 ml＋NDP 50 mg，静脉滴注，每周1次；DDP组化疗方案：0．9％氯化钠500 ml＋DDP 40 mg，静脉滴注，每周1次。2组均采用全程调强放疗。结果 NDP组和DDP组的呕吐发生率分别为53．3％、83．3％（P＜0．05）；血小板下降发生率分别为80．0％、50．0％（P＜0．05）；NDP组肾毒性发生率显著低于DDP组（P＜0．05）；2组白细胞下降、血红蛋白下降、肝脏毒性、口腔黏膜炎、耳神经毒性指标差异无统计学意义（P＞0．05）。2组有效率分别为93．4％、86．7％（P＞0．05）。结论NDP单药周方案同步化疗治疗局部晚期鼻咽癌的不良反应较DDP轻，患者依从性好，且与顺铂单药周方案同步化疗近期疗效相近。%Objective To observe the recent curative effects and side effects of nedaplatin ( NDP) and cisplatin ( DDP) single medicine week plan at the beginning of synchronous chemotherapy to treat the side effects of for local nasopharyngeal carci -noma and the recent curative effect .Methods 60 patients with locally advanced nasopharyngeal carcinoma treated with initial treatmentfirst ,were randomly divided into NPD group and DDP group ,30 cases in each ,NPD group of chemotherapy regimens:re-ceived 500 ml 0.9%sodium chloride+NDP 50 mg,static drop,1 times a week;DDP group chemotherapy regimens:received 500 ml 0.9%sodium chloride DDP 40 mg,static drop,1 times a week;Two groups of received intensity modulated radiation therapy (IMRT) adopt the whole.Results In NPD group and DDP group,the incidence of vomiting were 53.3% and 83.3%,respec-tively(P<0.05);Platelet decline rate were 80.0% and 50.0%,respectively(P<0.05);renal toxicity rate of NDP group was significantly below lower than DDP rates of renal toxicity group (P<0.05);Two groups of leucopenia ,hemoglobin descended leu-cocyte decrease incidence rate ,decreased hemoglobin ,two groups of liver toxicity ,oral cavity mucous membrane inflammation ,ear nerve toxicity index difference has d no statistical significance difference (P>0.05).Two groups of eEfficiencynt were 93.4%and 86.7%respectively(P>0.05).Conclusion The NDP single-agent weeks plan synchronization has less side effects in the treatment of for locally advanced nasopharyngeal carcinoma than DDP ,the patients compliance is good ,and synchronous chemo-therapy with cisplatin single-agent weeks schemes in the near future has similar curative effect .