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目的:观察放疗同步奈达铂每周给药治疗局部中晚期鼻咽癌的近期疗效及毒副反应。方法:将局部中晚期鼻咽癌随机分为治疗组和对照组,治疗组在放疗同时予以单药奈达铂(NDP)40 mg.m-2,每周1次,共7次,对照组为顺铂(DDP)40 mg.m-2,每周1次,共7次,均在放疗d 1用药。两组放疗方法相同,剂量相似,放疗结束后均予4周期TP方案(紫杉醇+顺铂)化疗。结果:放疗结束后3月评价近期疗效,NDP组和DDP组鼻咽部病灶完全消退率分别为88.9%和92.6%;颈部淋巴结完全消退率分别为92.6%和96.3%,两组比较差异无统计学意义(P>0.05);NDP组胃肠道反应发生率(7.1%)显著低于DDP组(64.3%)(P<0.05);两组白细胞下降发生率分别为57.1%和53.8%,差异无统计学意义(P>0.05),血小板下降发生率NDP组(42.9%)较DDP组(17.9%)高,差异有统计学意义(P<0.05)。结论:放疗联合NDP每周给药治疗局部中晚期鼻咽癌与联合DDP相比,近期疗效相当,但NDP治疗组有较少的胃肠道反应发生,其毒副反应主要是骨髓抑制所致的血小板减少。
OBJECTIVE: To observe the short-term curative effect and side effects of concurrent weekly nedaplatin administration for locally advanced nasopharyngeal carcinoma. Methods: The locally advanced and advanced nasopharyngeal carcinoma were randomly divided into treatment group and control group. The treatment group was treated with NDP 40 mg.m-2 once a week for 7 times while the control group For cisplatin (DDP) 40 mg.m-2, once a week, a total of 7 times, are treated with radiotherapy d1. Two groups of radiotherapy methods were the same, the dose was similar, after the end of radiotherapy are given 4 cycles of TP regimen (paclitaxel + cisplatin) chemotherapy. Results: The short-term curative effect was evaluated 3 months after the end of radiotherapy. The complete regression rate of nasopharyngeal lesions in NDP group and DDP group was 88.9% and 92.6%, respectively. The complete regression rate of cervical lymph nodes was 92.6% and 96.3% respectively. There was no significant difference between the two groups (P> 0.05). The incidence of gastrointestinal reaction (7.1%) in NDP group was significantly lower than that in DDP group (64.3%) (P <0.05). The incidences of leukopenia in the two groups were 57.1% and 53.8% The difference was not statistically significant (P> 0.05). The incidence of thrombocytopenia in NDP group (42.9%) was higher than that in DDP group (17.9%), the difference was statistically significant (P <0.05). CONCLUSION: Radiotherapy combined with weekly NDP treatment for locally advanced nasopharyngeal carcinoma has a similar short-term efficacy compared with combined DDP. However, fewer gastrointestinal reactions occurred in the NDP-treated group, with the main side effects being bone marrow suppression Thrombocytopenia.