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目的:比较多西他赛联合奈达铂(DN)与顺铂联合氟尿嘧啶(PF)诱导化疗及奈达铂单药同期放化疗治疗局部晚期鼻咽癌的急性不良反应、依从性及近期疗效。方法:经组织病理学确诊的局部晚期鼻咽癌患者64例,随机分为DN组和PF组。DN组和PF组患者分别接受DN或PF方案诱导化疗2个周期,随后行放疗以及2个周期的奈达铂单药同期化疗。观察两组患者治疗期间的不良反应和耐受性,以及近期疗效。结果:DN组的平均化疗周期数比PF组多(分别为3.63和3.06个周期,P=0.038)。DN组和PF组的3～4度中性粒细胞减少的发生率分别为37.50%和6.25%,差异有统计学意义(P=0.0025)。DN组患者的恶心和呕吐的发生率(6.25%)明显低于PF组(46.88%,P=0.0086)。两组的近期疗效及1年总生存率差异均无统计学意义(P>0.05)。结论:DN诱导化疗方案是治疗局部晚期鼻咽癌的有效方案,近期疗效与PF方案相似,在减少恶心和呕吐等胃肠反应方面,较PF方案显示出明显的优势。
OBJECTIVE: To compare the acute adverse reactions, compliance and short-term efficacy of docetaxel combined with nedaplatin (DN) with cisplatin plus fluorouracil (PF) -induced chemotherapy and nedaplatin single-drug concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma. Methods: 64 patients with locally advanced nasopharyngeal carcinoma diagnosed by histopathology were randomly divided into DN group and PF group. Patients in DN group and PF group received DN or PF regimen for induction of chemotherapy for 2 cycles, followed by radiotherapy and 2 cycles of nedaplatin single-agent concurrent chemotherapy. Adverse reactions and tolerability during the treatment were observed in both groups, as well as the recent efficacy. Results: The mean number of chemotherapy cycles in the DN group was more than in the PF group (3.63 and 3.06 cycles, respectively, P = 0.038). The incidence of 3- to 4-degree neutropenia in the DN and PF groups was 37.50% and 6.25%, respectively, with a significant difference (P = 0.0025). The incidence of nausea and vomiting in patients in DN group (6.25%) was significantly lower than that in PF group (46.88%, P = 0.0086). The two groups of short-term efficacy and 1-year overall survival rate difference was not statistically significant (P> 0.05). Conclusion: DN induction chemotherapy regimen is an effective treatment for locally advanced nasopharyngeal carcinoma. The recent curative effect is similar to that of PF regimen. Compared with PF regimen, DN induction chemotherapy regimen shows obvious advantages in reducing gastrointestinal reactions such as nausea and vomiting.