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动物实验已证明腺苷二磷酸核糖转移酶(ADPRT) 抑制剂烟酰胺(NA)对DDP、BLM等药物有选择性增效作用。本文采用DDP、5—Fu和BLM(PFB)或Carboplatin、5—Fu和BLM(CFB)治疗鼻咽癌(NPC)94例,并用前瞻性随机对照研究方法,首次对NA的化疗增效作用进行临床观察。结果试验组及对照组的缓解率和毒性反应均无统计学差异(P>0.05),未能证实NA的选择性增效作用。但临床试验所用NA剂量较动物实验治疗剂量明显为低,且病例较少,故仍值得作进一步临床研究。PFB治疗初治NPC30例,缓解率90％(27/30),放疗后局部复发和远处转移35例,缓解率51.43％(18/35);CFB治疗初治NPC22例,缓解率68.18(15/22)。PFB和CFB两组的缓解率和毒性反应发生率均无统计学差异(P>0.05),但CFB组的毒性反应恢复较快,提示Carboplatin对NPC的疗效与DDP相似而毒性反应较易恢复。PFB和CFB对NPC均有良好的近期疗效,且毒性较小,值得推广。
Animal experiments have demonstrated that nicotinamide (NA), an adenosine diphosphate ribose transferase (ADPRT) inhibitor, has a selective synergistic effect on drugs such as DDP and BLM. In this article, 94 cases of nasopharyngeal carcinoma (NPC) were treated with DDP, 5-Fu and BLM (PFB) or Carboplatin, 5-Fu, and BLM (CFB), and a first-time prospective randomized controlled study was performed. Clinical Observation. Results There was no significant difference in remission rate and toxicity between the experimental group and the control group (P>0.05), and the selectivity and synergism of NA could not be confirmed. However, the dose of NA used in clinical trials was significantly lower than that in animal experiments, and there were fewer cases, so it is still worth further clinical studies. 30 cases of primary NPC were treated with PFB, the remission rate was 90% (27/30), 35 cases were local recurrence and distant metastasis after radiotherapy, the remission rate was 51.43% (18/35); 22 cases of NPC were treated with CFB, and the remission rate was 68.18 (15 /twenty two). There was no significant difference in the remission rate and the incidence of toxic reactions between the two groups (P>0.05). However, the toxicity of CFB group recovered rapidly, suggesting that the efficacy of Carboplatin on NPC is similar to that of DDP and the toxicity is easier to recover. Both PFB and CFB have good short-term efficacy on NPC, and they are less toxic and worthy of promotion.