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目的观察局部区域晚期鼻咽癌同期放化疗联合辅助化疗的不良反应。方法将2006年1月至2009年12月间平顶山市第二人民医院肿瘤科收治的晚期鼻咽癌患者随机分为观察组和对照组,每组28例,对照组采用同期放化疗治疗,观察组采用同期放化疗联合辅助化疗治疗。两组患者均采取常规根治性放疗,放疗期间给予顺铂40 mg/m2,第1天,每周1次,连续7周;观察组放疗结束后1个月后给予辅助化疗,顺铂80 mg/m2,第1天,5-FU800 mg/m2,第1~5天,4周为1个疗程,共3个疗程,比较两组患者不良反应的发生情况。结果①观察组鼻咽癌原发灶和颈部淋巴结完全缓解率比对照组高,两组比较差异有统计学意义(P<0.05)。②观察组出现血小板减少、白细胞减少、胃肠道反应、3~4级损伤等情况的发生率较对照组高,两组比较差异有统计学意义(P<0.05);56例患者均按计划完成放疗,32.1%(18/56)患者完成7次同期化疗;78.6%(44/56)患者完成6次同期化疗,89.3%(50/56)患者完成5次同期化疗。结论局部同期放化疗联合辅助化疗治疗区域晚期鼻咽癌疗效较单纯放射治疗好,可明显提高原发灶及颈部淋巴结的消退率,但患者不良反应发生率较高。
Objective To observe the adverse reactions of adjuvant chemotherapy combined with adjuvant chemotherapy in advanced nasopharyngeal carcinoma in the local area. Methods From January 2006 to December 2009 Pingdingshan Second People’s Hospital Department of Oncology patients with advanced nasopharyngeal carcinoma were randomly divided into observation group and control group, 28 cases in each group, the control group was treated with concurrent radiotherapy and chemotherapy, observed Group using the same period of radiotherapy and chemotherapy combined with adjuvant chemotherapy. Patients in both groups were treated with conventional radical radiotherapy. Cisplatin 40 mg / m2 was given during radiotherapy, on the first day, once a week for 7 weeks. In the observation group, adjuvant chemotherapy was given one month after the end of radiotherapy and cisplatin 80 mg / m2 on the first day, 5-FU800 mg / m2, 1 to 5 days, 4 weeks for a course of treatment, a total of 3 courses, the incidence of adverse reactions in both groups were compared. Results ① The complete remission rate of NPC and cervical lymph node in observation group was higher than that of control group, the difference was statistically significant (P <0.05). ② The incidence of thrombocytopenia, leukopenia, gastrointestinal reactions and grade 3 to 4 injuries in the observation group were higher than those in the control group, with significant difference between the two groups (P <0.05); 56 patients were scheduled Radiotherapy was completed in 32.1% (18/56) patients, while 7 (7) chemotherapy cycles were completed in 78.1% (18/56) patients. Six cycles of concurrent chemotherapy were performed in 78.6% (44/56) of patients and 89.3% (50/56) of patients completed 5 concurrent chemotherapies. Conclusions Local concurrent chemoradiotherapy combined with adjuvant chemotherapy is superior to radiotherapy alone in the treatment of advanced nasopharyngeal carcinoma. It can significantly improve the rate of regression of primary tumor and cervical lymph nodes, but the incidence of adverse reactions in patients is higher.