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为了观察和比较吉西他滨联合顺铂(GP)及氟尿嘧啶联合顺铂(FP)同期放化疗治疗局部晚期鼻咽癌患者的近期疗效和耐受性,将经病理确诊的局部晚期鼻咽癌(T3-4N1-3M0)患者56例,分为GP组27例和FP组29例。GP组化疗在放疗第1,5周给予吉西他滨1000mg/m2,d1,d8+顺铂25mg/m2,d1～d3,静脉滴入。FP组化疗在放疗第1,5周给予5-FU500mg/m2,d1～d5+顺铂25mg/m2,d1～d3,静脉滴入。两组放疗方案相同,均为飞利浦直线加速器(能量为6MVX线)常规照射,鼻咽部总放疗剂量(70～72)Gy/(35～36)次,2Gy/次,颈部淋巴结总放疗剂量(60～70)Gy/(30～35)次,2Gy/次。治疗结束后行肿瘤疗效评价,GP组近期有效率为100%,CR21例;FP组有效率为96.6%,CR18例。GP组与FP组Ⅲ～Ⅵ级恶心、呕吐发生率分别为11.1%、13.8%(P>0.05),骨髓抑制发生率分别为29.6%、17.2%(P<0.05),皮肤反应发生率分别为18.5%、27.6%(P<0.05),口腔黏膜反应发生率分别为14.8%、24.1%(P<0.05)。初步研究结果提示,采用GP方案同期放化疗治疗局部晚期鼻咽癌近期疗效优于FP方案,毒副反应可耐受,值得临床应用。
To observe and compare the short-term efficacy and tolerability of gemcitabine combined with cisplatin (GP) and fluorouracil combined with cisplatin (FP) concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma, pathologically confirmed locally advanced nasopharyngeal carcinoma (T3- 4N1-3M0) patients 56 cases, divided into GP group 27 cases and FP group 29 cases. The GP group received Gemcitabine 1000 mg / m2, d1, d8 + Cisplatin 25 mg / m2, d1 ~ d3 in the first week after radiotherapy. FP group chemotherapy in the first week after radiotherapy given 5-FU500mg / m2, d1 ~ d5 + cisplatin 25mg / m2, d1 ~ d3, intravenous infusion. The two radiotherapy regimens were the same, all of them were routinely irradiated by Philips linear accelerator (energy 6MVX line), total radiation dose of nasopharyngeal (70-72 Gy / (35-36) times, 2Gy / time, total radiotherapy dose (60 ~ 70) Gy / (30 ~ 35) times, 2Gy / time. Tumor efficacy evaluation after the end of treatment, GP group, the recent efficiency was 100%, CR21 cases; FP group was 96.6%, CR18 cases. The incidences of grade Ⅲ ~ Ⅵ nausea and vomiting in GP group and FP group were 11.1% and 13.8%, respectively (P> 0.05). The incidence of myelosuppression was 29.6% and 17.2% respectively (P <0.05). The incidences of skin reactions were 18.5%, 27.6% respectively (P <0.05). The incidence of oral mucosal reaction was 14.8% and 24.1% respectively (P <0.05). Preliminary results suggest that the use of GP regimen of concurrent chemoradiotherapy for the treatment of locally advanced nasopharyngeal carcinoma is better than the FP effect of the recent program, toxic side effects are tolerable, worthy of clinical application.