论文部分内容阅读
目的:探讨5-FU、DDP时间调节给药法治疗晚期鼻咽癌的不良反应及疗效。方法:2001年3月到2003年1月,中山大学肿瘤防治中心鼻咽癌科对30例经病理学证实未接受过化疗的晚期鼻咽癌患者进行时间调节化疗,其中初治局部晚期(诱导化疗组)20例,初治转移、治疗后复发和(或)转移(单纯化疗组)10例。应用Melodie多通道编程输液泵进行电脑调控的正弦曲线形式时间调节给药。诱导化疗组于第1～5天、第22～26天分别行2程诱导化疗,方案为5-FU750～850mg/m2·天;DDP20mg/m2·天,连续给药5天,5-FU由22h至第2天早10h给药,浓度高峰为凌晨4h;DDP由早10h至晚22h给药,浓度高峰为下午4h,第5周开始放疗。单纯化疗组行2～6程化疗,方案为5-FU600mg/m2·天;LV200mg/m2·天;DDP20mg/m2·天,连续给药5天,每3周重复,给药方法及达峰时间与诱导化疗组相同,其中LV与5-FU给药方法一致。结果:诱导化疗组2程化疗后有效率(PR)达100%;全疗程结束CR达95.0%(19/20)。单纯化疗组PR80.0%(8/10),病情稳定(SD)10.0%(1/10),病情进展(PD)10.0%(1/10)。两组不良反应主要为Ⅲ～Ⅳ度迟发性血小板减少,发生于26.7%(8/30)的患者、14.1%(13/92)的疗程,其余不良反应有轻微性差异。结论:晚期鼻咽癌时间调节化疗不良反应小,疗效明确,值得进行深入临床研究。
Objective: To investigate the side effects and therapeutic effects of 5-FU and DDP in the treatment of advanced nasopharyngeal carcinoma. Methods: From March 2001 to January 2003, the nasopharyngeal carcinoma department of Sun Yat-sen University Cancer Center for Thirty patients with pathologically confirmed advanced nasopharyngeal carcinoma who had not received chemotherapy were time-adjusted chemotherapy. Among them, locally advanced (induction Chemotherapy group) 20 cases, initial treatment metastasis, recurrence and / or metastasis (simple chemotherapy group) in 10 cases. Computer-controlled sinusoidal time-adjusted dosing with Melodie multichannel programming infusion pump. Induction chemotherapy in the first 5 days, 22 to 26 days were 2-way induction chemotherapy, the program for the 5-FU 750 ~ 850mg / m2 day; DDP20mg / m2 day, continuous administration of 5 days, 5-FU from 22h to the early morning of the second day of 10h administration, the peak concentration of 4h; DDP as early as 10h to late 22h administration, the peak concentration of 4h, the first 5 weeks of radiotherapy. The chemotherapy alone group was given 2 to 6 courses of chemotherapy with the dosage of 5-FU 600 mg / m 2 · day, LV 200 mg / m 2 · day, DDP 20 mg / m 2 · day, continuous administration for 5 days and repeated every 3 weeks. The same as the induction chemotherapy group, which LV and 5-FU administration method. Results: The effective rate (PR) was 100% after 2 cycles chemotherapy in induction chemotherapy group and 95.0% (19/20) at the end of the whole course of chemotherapy. PR80.0% (8/10), stable disease (SD) 10.0% (1/10) and disease progression (PD) 10.0% (1/10) in the chemotherapy group. Two groups of adverse reactions are mainly Ⅲ ~ Ⅳ delayed thrombocytopenia occurred in 26.7% (8/30) of patients, 14.1% (13/92) of the course of treatment, the remaining adverse reactions were slightly different. Conclusion: Time-adjusted chemotherapy for advanced nasopharyngeal carcinoma has a small adverse reaction and a clear curative effect, which is worth further clinical study.