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目的:评价顺铂不同给药方案同期放化疗治疗鼻咽癌的急性毒副反应及耐受性。方法:2012年3月-10月共160例患者进入本研究,按顺铂不同给药方案随机分为八组(A组、DDP100mg/m~2,d1,q4w;B组、DDP100mg/m~2,分三天用,q4w;C组、DDP80mg/m~2,d1,q4w;D组、DDP80mg/m~2,分三天用,q4w;E组、DDP100mg/m~2,d1,q3w;F组、DDP100mg/m~2,分三天用,q3w;G组、DDP80mg/m~2,d1,q3w;H组、DDP80mg/m~2,分三天用,q3w),均行2周期化疗。各组放疗方案相同,采用常规放疗或调强适形放疗,原发肿瘤和阳性淋巴结总剂量为62~78Gy。结果:主要的急性毒副反应包括:白细胞减少(A组:85%,B组:90%,C组:95%,D组:90%,E组:95%,F组:90%,G组:95%,H组:90%;χ~2=5.312,P=0.622),贫血(A组:95%,B组:85%,C组:90%,D组:85%,E组:100%,F组:95%,G组:80%,H组:100%;χ~2=13.543,P=0.060),呕吐(A组:100%,B组:100%,C组:100%,D组:100%,E组:100%,F组:100%,G组:90%,H组:90%;χ~2=22.534,P=0.068),体重下降(A组:100%,B组:100%,C组:95%,D组:95%,E组:100%,F组:95%,G组:95%,H组:100%;χ~2=9.150,P=0.821),皮肤反应、粘膜反应、口干各组发生率均为100%。各组急性毒副反应发生率无显著差异,所有的并发症经对症支持治疗后均能恢复。结论:顺铂100mg/m~2与80mg/m~2及不同的剂量分割和间隔时间同步化疗治疗鼻咽癌的急性毒副反应发生率无显著差异,患者均能耐受。
OBJECTIVE: To evaluate the acute toxicity and tolerance of nasopharyngeal carcinoma treated with concurrent chemotherapy with different doses of cisplatin. METHODS: A total of 160 patients were enrolled in this study from March to October of 2012. They were randomly divided into eight groups according to different cisplatin regimens (group A, DDP 100 mg/m~2, d1, q4w; group B, DDP 100 mg/m~ 2, divided into three days, q4w; C group, DDP80mg/m~2, d1, q4w; D group, DDP80mg/m~2, divided into three days, q4w; E group, DDP100mg/m~2, d1, q3w F group, DDP 100mg/m~2, divided into three days, q3w; G group, DDP80mg/m~2, d1, q3w; H group, DDP80mg/m~2, divided into three days, q3w), all 2 Cycle chemotherapy. The radiotherapy protocols were the same in all groups. Conventional radiotherapy or intensity-modulated conformal radiotherapy was used. The total dose of primary tumors and positive lymph nodes was 62-78 Gy. RESULTS: The main acute toxicity included: leucopenia (A: 85%, B: 90%, C: 95%, D: 90%, E: 95%, F: 90%, G Group: 95%, Group H: 90%; χ~2=5.312, P=0.622), Anemia (Group A: 95%, Group B: 85%, Group C: 90%, Group D: 85%, Group E) : 100%, Group F: 95%, Group G: 80%, Group H: 100%; χ~2=13.543, P = 0.060), Vomiting (Group A: 100%, Group B: 100%, Group C: 100%, Group D: 100%, Group E: 100%, Group F: 100%, Group G: 90%, Group H: 90%; χ 2 2 = 22.534, P = 0.068), Weight loss (Group A: 100%, Group B: 100%, Group C: 95%, Group D: 95%, Group E: 100%, Group F: 95%, Group G: 95%, Group H: 100%; χ~2= 9.150 (P=0.821). The incidence of skin reactions, mucosal responses, and dry mouth was 100%. There was no significant difference in the incidence of acute toxic side reactions in all groups. All complications were recovered after symptomatic supportive treatment. CONCLUSIONS: The incidence of acute toxicity of nasopharyngeal carcinoma with cisplatin 100 mg/m~2 and 80 mg/m~2 and different dose-fractionation and interval-time synchronous chemotherapy has no significant difference and patients can tolerate.