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对比观察大剂量醛氢叶酸 (CF)、5 氟尿嘧啶 ( 5 Fu)、顺铂 (DDP) (PFL方案 )与DDP + 5 Fu(PF方案 )联合化疗对晚期鼻咽癌的临床疗效及安全性。方法 :1 997年 1月— 1 999年 1月间 ,5 8例经病理证实的晚期鼻咽癌患者 ,非随机分为PFL组 2 8例 (按PFL方案化疗 ) ,PF组 30例 (按PF方案化疗 )。结果 :PFL组CR率、有效率分别为 1 7.9%、6 4 .3% ,中位生存期 1 4月 ( 4— 2 1月 )。PF组其CR率、有效率分别为 1 0 %、46 .7% ,中位生存期 1 1 .5月( 2 .5— 2 2 .5月 )。两组CR率及有效率、中位生存期无显著性差异 (P >0 .0 5 )。PFL及PF方案化疗对鼻咽肿物、颈部或腹部淋巴结转移、肺转移效果较好 ,对骨转移虽客观缓解率不高 ,但止痛效果较好 ,对肝转移效果较差。PFL组其WBC下降率有显著性差异 (P <0 .0 5 ) ,Ⅲ—Ⅳ级WBC下降率有非常明显的显著性差异 (P <0 .0 1 ) ;口腔炎、脱发的发生率有非常明显的显著性差异 (P <0 .0 1 ) ,其他毒性反应相似 (P >0 .0 5 )。结论 :PFL方案为鼻咽癌较为有效的治疗方案
To observe the clinical efficacy and safety of high-dose combination of 5-fluorouracil (5 Fu), cisplatin (DDP) (PFL) and DDP + 5 Fu (PF) in the treatment of advanced nasopharyngeal carcinoma. Methods: Between January 1997 and January 1999, 58 patients with pathologically confirmed advanced nasopharyngeal carcinoma were randomly divided into PFL group (n = 28) and PF group (n = 28) PF regimen chemotherapy). Results: The CR rate and effective rate in PFL group were 1 7.9% and 64.3%, respectively. The median survival time was 14 months (April to January). The CR rate and effective rate in PF group were 10% and 46.7% respectively, and the median survival time was 11.5 months (2.5-2.2.5 months). There was no significant difference in CR rate, effective rate and median survival between the two groups (P> 0.05). PFL and PF chemotherapy for nasopharyngeal tumor, neck or abdominal lymph node metastasis, lung metastasis better, although the objective rate of bone metastasis is not high, but the analgesic effect is better, less effective on liver metastases. There was a significant difference in the rate of WBC decline between the two groups (P <0.05), and the rate of grade Ⅲ-Ⅳ WBC decreased significantly (P <0.01). The incidence of stomatitis and alopecia was Significantly significant difference (P <0. 01), other toxic reactions were similar (P> 0.05). Conclusion: The PFL regimen is a more effective treatment for nasopharyngeal carcinoma