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目的观察多西他赛和顺铂序贯放化疗治疗局部晚期喉癌的治疗效果。方法选取作者医院于2008-01/2010-01月收治的50例局部晚期喉癌患者,将其随机均分为观察组和对照组,每组25例,两组均给予相同方式的常规放疗,放疗前给予2周期的化疗,观察组给予多西他赛60 mg/m2静脉滴注d1、顺铂25 mg/m2静脉滴注d1~3,28 d为一个周期;对照组给予顺铂25 mg/m2静脉滴注d1~3以及氟尿嘧啶400 mg/m2静脉滴注d1~5,28 d为一个周期。治疗结束后观察两组的近期疗效及不良反应,随访5年观察患者的生存时间。结果观察组的总有效率(response rate,RR)为84%(21/25),对照组为64%(16/25),组间比较差异有统计学意义(P<0.05)。多西他赛联合顺铂(TP)方案治疗后出现Ⅲ~Ⅳ度胃肠道反应、骨髓抑制等近期不良反应的发生率与顺铂联合氟尿嘧啶(PF)方案相比较差异无统计学意义(P>0.05),且Ⅲ~Ⅳ度喉水肿、喉软骨炎以及喉软骨坏死等远期不良反应的发生率两组比较差异无统计学意义(P>0.05)。TP化疗后中位生存时间为3.3年,PF方案化疗后为2.8年,组间比较差异无统计学意义(P>0.05)。结论 TP方案化疗联合放疗对于局部晚期喉癌可以起到更好的近期疗效,且不良反应可耐受,值得推广应用。
Objective To observe the effect of docetaxel and cisplatin sequential chemoradiotherapy in the treatment of locally advanced laryngeal cancer. Methods Fifty patients with locally advanced laryngeal cancer who were admitted to our hospital from January 2008 to January 2010 were randomly divided into observation group and control group, with 25 cases in each group. Both groups were given the same mode of conventional radiotherapy, The patients in the observation group were given intravenous infusion of docetaxel 60 mg / m2 d1, intravenous infusion of 25 mg / m2 of cisplatin d1-3, 28 d for one cycle. The control group was given cisplatin 25 mg / m2 intravenous drip d1 ~ 3 and fluorouracil 400 mg / m2 intravenous d1 ~ 5,28 d for a cycle. After treatment, the two groups were observed the short-term efficacy and adverse reactions, followed up for 5 years to observe the patient’s survival time. Results The total response rate (RR) of the observation group was 84% (21/25), while that of the control group was 64% (16/25). The difference between the two groups was statistically significant (P <0.05). Docetaxel combined with cisplatin (TP) regimen after Ⅲ ~ Ⅳ gastrointestinal reactions, the incidence of adverse reactions such as bone marrow suppression and cisplatin combined with fluorouracil (PF) program was no significant difference (P > 0.05). There was no significant difference in the incidence of long-term adverse reactions such as laryngeal edema Ⅲ ~ Ⅳ, laryngromachitis and laryngeal cartilage necrosis between the two groups (P> 0.05). The median survival time of TP was 3.3 years after chemotherapy and 2.8 years after PF regimen chemotherapy. There was no significant difference between the two groups (P> 0.05). Conclusion TP regimen combined with radiotherapy for local advanced laryngeal cancer can play a better short-term efficacy, and adverse reactions are tolerable, it is worth promoting the application.