论文部分内容阅读
目的对比TPS1/TPF两种不同新辅助化疗方案治疗局部晚期鼻咽癌的近期疗效和安全性。方法选择2015年12月~2016年8月我院收治的72例局部晚期鼻咽癌患者,随机分为两组。TPS1组行新辅助化疗2周期(多西他赛60mg·m~(-2)、d1,顺铂60 mg·m~(-2)、d1,替吉奥(S-1)60 mg·m~(-2)、d1~14,每天分2次口服)。TPF组行新辅助化疗2周期(多西他赛60 mg·m~(-2)、d1,顺铂60mg·m~(-2)、d1,5-FU 600 mg·m~(-2)、d1~5)。两组患者在2周期新辅助化疗后开始同步放化疗,放疗处方剂量为:PGTVnx:70.4 Gy/32 f,PGTVnd:70.4 Gy/32 f,PCTV1:64 Gy/32 f,PCTV2:57.6 Gy/32 f,PCTV3:50.4 Gy/28 f。同步化疗方案为DDP单药80 mg·m~(-2),2周期。比较两组患者的临床疗效及毒副反应发生情况。结果新辅助化疗后,TPS1组CR率13.5%,TPF组CR率11.4%,两组比较差异无统计学意义(P=0.979)。完成同步放化疗后,TPS1组CR率75.7%,TPF组CR率77.1%,两组比较差异无统计学意义(P=0.884)。治疗结束3个月后复查整体(鼻咽+颈部),TPS1组CR率83.8%,TPF组CR率80.0%,两组比较差异无统计学意义(P=0.679)。新辅助化疗后,TPS1组无4级反应,耐受良好,TPS1组1~2级腹胀、腹痛发生率高于TPF组(P<0.05),主要急性毒性反应为血液毒性和消化道反应。整体放化疗结束后,两组均无4级毒性反应发生,主要毒性反应为放射性皮炎、口腔黏膜炎、口干和血液毒性,两组比较差异无统计学意义(P>0.05)。结论与TPF新辅助化疗方案相比,TPS1新辅助化疗方案对局部期鼻咽癌的疗效相当,但安全性更高。
Objective To compare the short-term efficacy and safety of two different neoadjuvant chemotherapy regimens of TPS1 / TPF in the treatment of locally advanced nasopharyngeal carcinoma. Methods Seventy-two patients with locally advanced nasopharyngeal carcinoma admitted from December 2015 to August 2016 in our hospital were randomly divided into two groups. TPS1 group received neoadjuvant chemotherapy for 2 cycles (docetaxel 60 mg · m -2, d 1, cisplatin 60 mg · m -2, d 1, T-60 mg · m -1 ~ (-2), d1 ~ 14, 2 times a day orally). In the TPF group, two cycles of neoadjuvant chemotherapy (docetaxel 60 mg · m -2, d 1, cisplatin 60 mg · m -2, d 1.5-FU 600 mg · m -2) , D1 ~ 5). The two groups of patients started concurrent chemoradiation after 2 cycles of neoadjuvant chemotherapy with the prescription dose of PGTVnx: 70.4 Gy / 32 f, PGTVnd: 70.4 Gy / 32 f, PCTV1: 64 Gy / 32 f, PCTV2: 57.6 Gy / 32 f, PCTV3: 50.4 Gy / 28 f. Synchronous chemotherapy program for the DDP single drug 80 mg · m ~ (-2), 2 cycles. The clinical efficacy and side effects of the two groups were compared. Results After neoadjuvant chemotherapy, CR rate was 13.5% in TPS1 group and 11.4% in TPF group, there was no significant difference between the two groups (P = 0.979). After completion of concurrent chemoradiotherapy, CR rate was 75.7% in TPS1 group and 77.1% in TPF group. There was no significant difference between the two groups (P = 0.884). Three months after the end of treatment, the overall review (nasopharyngeal + neck) was 83.8% in the TPS1 group and 80.0% in the TPF group. There was no significant difference between the two groups (P = 0.679). After neoadjuvant chemotherapy, there was no grade 4 response in TPS1 group, which was well tolerated. The incidence of abdominal distension and abdominal pain in grade 1 ~ 2 of TPS1 group was higher than that of TPF group (P <0.05). The main acute toxicity was hematotoxicity and gastrointestinal reaction. After the end of radiotherapy and chemotherapy, there was no grade 4 toxicity in both groups. The main toxicities were radiodermatitis, oral mucositis, dry mouth and hematological toxicity. There was no significant difference between the two groups (P> 0.05). Conclusions Compared with TPF neoadjuvant chemotherapy, TPS1 neoadjuvant chemotherapy regimen has the same efficacy as local nasopharyngeal carcinoma but is more safe.