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[目的]比较顺铂单药每周方案与每3周方案配合同期放疗治疗局部晚期鼻咽癌的近期疗效、毒副作用及耐受性。[方法]65例局部晚期鼻咽癌患者,随机分为两组,治疗组:33例患者接受顺铂每周方案,30mg/m2,d1;对照组:32例患者接受顺铂单药每3周方案,80mg/m2,d1、d22、d43。两组均配合常规放射治疗,放疗方法相同。[结果]治疗组与对照组患者的近期有效率均为100%;治疗组1年累积复发率及无复发生存率(RFS)、1年累积远处转移率及无远处转移生存率(MFS)分别为9.1%、90.9%、12.1%、87.9%,对照组分别为9.4%、90.6%、15.6%、84.4%,两组比较无统计学差异。对照组Ⅲ～Ⅳ级粒细胞毒性、口腔黏膜反应及胃肠道反应分别为25.0%、28.1%、25.0%,较治疗组的3.0%、6.1%、3.0%重,差异有统计学意义(P<0.05)。[结论]顺铂单药每周方案给药与每3周方案给药配合同期放疗治疗局部晚期鼻咽癌疗效确切,但每周方案组患者毒副反应较每3周方案组轻,耐受性更好。
[Objective] To compare the short-term efficacy, side effects and tolerability of cisplatin monotherapy weekly versus every 3 weeks with concurrent radiotherapy for locally advanced nasopharyngeal carcinoma. [Method] 65 patients with locally advanced nasopharyngeal carcinoma were randomly divided into two groups: treatment group: 33 patients received cisplatin weekly program, 30mg / m2, d1; control group: 32 patients received cisplatin alone every 3 Week program, 80mg / m2, d1, d22, d43. Both groups are with conventional radiation therapy, radiation the same way. [Results] Both the treatment group and the control group had an effective rate of 100%. The 1-year cumulative recurrence rate, recurrence-free survival rate (RFS), cumulative 1-year distant metastasis rate and distant metastasis-free survival rate ) Were 9.1%, 90.9%, 12.1% and 87.9% respectively, while those in the control group were 9.4%, 90.6%, 15.6% and 84.4% respectively. There was no significant difference between the two groups. The cytotoxicity of grade Ⅲ ~ Ⅳ, oral mucosal reaction and gastrointestinal reaction in control group were 25.0%, 28.1% and 25.0% respectively, which were significantly higher than those in the treatment group (3.0%, 6.1% and 3.0% <0.05). [Conclusion] The weekly administration of cisplatin alone has the same effect as the administration of radiotherapy every three weeks in the treatment of locally advanced nasopharyngeal carcinoma. However, the toxicity of the cisplatin alone is more tolerable than that of the 3-week administration Sex better.