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目的对比分析诱导化疗加同步放化疗治疗局部晚期鼻咽癌的临床疗效。方法 148例患者随机分为治疗组与对照组,各74例。治疗组患者采用奈达铂(NDP)联合替加氟(FT-207)诱导化疗加放射治疗同步奈达铂化疗方案,对照组患者采用顺铂(DDP)联合氟尿嘧啶(5-Fu)诱导化疗加放射治疗同步顺铂化疗方案,观察两组患者的临床疗效、生存率和不良反应发生情况。结果治疗组患者鼻咽部肿瘤完全消退率为95.9%,有效率为98.6%;颈部淋巴结完全消退率为94.6%,有效率为98.6%。对照组患者鼻咽部肿瘤完全消退率为93.2%,有效率为98.64%;颈部淋巴结完全消退率为89.2%,有效率为97.3%,两组患者近期疗效差异无统计学意义(P>0.05);诱导化疗中,治疗组患者恶心呕吐、白细胞减少发生率低于对照组,差异有统计学意义(P<0.05)。同期化疗中,治疗组患者血小板减少发生率低于对照组,差异有统计学意义(P<0.05);两组患者总生存率、无复发生存率和无转移生存率比较,差异均无统计学意义(P>0.05)。结论奈达铂和替加氟诱导化疗联合同期放射治疗与顺铂和氟尿嘧啶诱导化疗联合同期化疗疗效相当,而且奈达铂和替加氟方案消化道不良反应、白细胞减少情况优于顺铂和氟尿嘧啶方案,值得推广,远期疗效有待观察。
Objective To compare the clinical efficacy of induction chemotherapy with concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma. Methods 148 patients were randomly divided into treatment group and control group, 74 cases in each. The patients in the treatment group were treated with NDP plus tegafur (FT-207) induction chemotherapy plus radiation, and the control group was treated with cisplatin (DDP) combined with 5-Fu induction chemotherapy Radiotherapy cisplatin chemotherapy regimen, observation of two groups of patients with clinical efficacy, survival and adverse reactions. Results The complete regression rate of nasopharyngeal tumor in treatment group was 95.9% and the effective rate was 98.6%. The complete regression rate of cervical lymph node was 94.6% and the effective rate was 98.6%. In control group, the complete regression rate of nasopharyngeal tumor was 93.2% and the effective rate was 98.64%. The complete regression rate of cervical lymph node was 89.2% and the effective rate was 97.3%. There was no significant difference in short-term curative effect between the two groups (P> 0.05 ); Induction chemotherapy, the treatment group patients with nausea and vomiting, leukopenia incidence was lower than the control group, the difference was statistically significant (P <0.05). In the same period of chemotherapy, the incidence of thrombocytopenia in the treatment group was lower than that in the control group (P <0.05). There was no significant difference in the overall survival, recurrence-free survival and metastasis-free survival between the two groups Significance (P> 0.05). Conclusion Nedaplatin and tegafur induction chemotherapy combined with concurrent radiotherapy and cisplatin and fluorouracil induction chemotherapy combined with the same period of chemotherapy, nedaplatin and tegafur regimen gastrointestinal adverse reactions, leukopenia than cisplatin and fluorouracil Program, worth promoting, long-term efficacy remains to be seen.