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目的观察TPF方案诱导化疗联合同步放化疗治疗局部晚期鼻咽癌的疗效及不良反应。方法 2009年1月至2010年1月,60例局部晚期鼻咽癌随机分为诱导化疗加同步放化疗(试验组,30例)和同步放化疗(对照组,30例)。两组放疗方法相同,均采用调强放射治疗(IMRT)。试验组TPF方案(多西他赛75mg/m2,d1,顺铂75mg/m2,d1,氟尿嘧啶500mg/m2,d1～5 q3w×2)诱导化疗+同期放化疗(顺铂每周40mg/m2加同步IMRT)。对照组同期放化疗(顺铂每周40mg/m2加同步IM-RT)。结果试验组和对照组近期疗效比较差异无统计学意义(P>0.05)。2年局部控制率试验组为96.6%,对照组为86.6%(P>0.05)。2年无远处转移生存率试验组为93.3%(28/30),对照组为70.0%(21/30)(P<0.05)。试验组Ⅲ/Ⅳ级白细胞及血小板下降明显高于对照组(P<0.05)。结论诱导化疗加同步放化疗治疗局部晚期鼻咽癌疗效较好,且不良反应可耐受。
Objective To observe the efficacy and adverse reactions of TPF-induced chemotherapy combined with concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma. Methods From January 2009 to January 2010, 60 patients with locally advanced nasopharyngeal carcinoma were randomly divided into induction chemotherapy combined with chemoradiotherapy (experimental group, 30 cases) and concurrent chemoradiotherapy (control group, 30 cases). The same two methods of radiotherapy, are using intensity-modulated radiation therapy (IMRT). The experimental group TPT program (docetaxel 75mg / m2, d1, cisplatin 75mg / m2, d1, fluorouracil 500mg / m2, d1 ~ 5q3w × 2) chemotherapy and concurrent chemoradiotherapy (cisplatin 40mg / m2 Synchronous IMRT). Control group concurrent radiotherapy and chemotherapy (cisplatin weekly 40mg / m2 plus synchronous IM-RT). Results There was no significant difference in short-term curative effect between experimental group and control group (P> 0.05). The 2-year local control rate was 96.6% in the trial group and 86.6% in the control group (P> 0.05). The 2-year survival rate without distant metastasis was 93.3% (28/30) in the trial group and 70.0% (21/30) in the control group (P <0.05). The level of Ⅲ / Ⅳ white blood cells and platelets in the experimental group were significantly lower than those in the control group (P <0.05). Conclusion Induction chemotherapy plus concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma has good efficacy and tolerable adverse reactions.