期刊文献+

含紫杉醇化疗联合体外放射治疗中晚期鼻咽癌的临床研究

Time and sequential chemotherapy combined with radiotherapy in treatment of advanced nasopharyngeal carcinoma
下载PDF
导出
摘要 目的观察紫杉醇+顺铂(PD)方案化疗联合体外放射治疗对晚期鼻咽癌的疗效。方法150例Ⅲ~Ⅳa期中晚期鼻咽癌患者均衡设计随机均分为3组。对照组单纯常规分割放射治疗;序贯组常规分割放射治疗后予PD方案化疗3~4个周期;交替组予PD方案化疗1个周期后常规分割放射治疗,在放射治疗中再单药紫杉醇化疗1~2个周期,放射治疗结束后再予PD方案化疗3个周期。PD方案:紫杉醇135mg/m^2静脉滴注,持续4h,第1天给药;顺铂80mg/m^2静脉滴注,分3d给药,21d为1个周期。照射用6mV X线,每次肿瘤量2Gy,7~8周,原发灶肿瘤照射剂量(DT)70~80Gy,颈部预防照射D_T 50~56 Gy,颈部转移灶D_T 65~70Gy。结果交替组完全缓解率(98%)和3年生存率(84%)均明显高于序贯组(86%和68%)和对照组(82%和56%,P值均<0.05)。交替组和序贯组的远处转移率分别为6%和8%,明显低于对照组的22%(P值均<0.05)。结论PD方案化疗和放射治疗交替可促进局部肿块的消退,提高远期疗效;PD方案可作为晚期鼻咽癌的首选化疗方案。 Objective To evaluate the efficacy of radiotherapy combined with chemotherapy for advanccd nasopharyngeal carcinoma. Methods We randomly divided 150 patients with Ⅲ-Ⅳa stage of nasopharyngeal carcinoma (NPC) into three groups according to the timing and sequential chemotherapy combined with radiotherapy. ① Control group (n = 50) : conventional radiotherapy only. ② Sequential group (n = 50) : Conventional radiotherapy was given first and followed by four courses of chemotherapy. ③Alternating group(n = 50) : radiotherapy was given after the first cycle of chemotherapy and followed by three cycles of chemotherapy. Chemotherapy regimen (PD) : contained (135 mg/m^2 , iv) paclitaxel and DDP(80 mg/m^2 , d1-3). The primary tumor received a total dose of 70-80 Gy with 2 Gy perday by 6 MV X ray. Patients with cervical lymph node metastasis received 65-70 Gy over the neck whereas patients with no cervical lymph node metastasis received only a prophylactic radiation of 50-56 Gy. Results Among the three groups complete remission rate of primary lesion of nasopharynx was the alternating group, showing a significant statistical difference(P 〈 0.05). Three-year survival rate was also higher in the alternating group than those of the other two groups(P 〈 0.05). The distant metastasis rates were significantly lower in the sequential group and alternating group than that in the control group (P〈0.05). Conclusions PD chemotherapy regimen can accelerate primary tumor remission, improve the survival rate and lower the metastastic potentiality in patients with advanced nasopharyngeal carcinoma and should be the first, choice
出处 《上海医学》 CAS CSCD 北大核心 2006年第11期763-765,共3页 Shanghai Medical Journal
基金 湖南省自然科学基金(03jjy3058)
关键词 鼻咽肿瘤 药物疗法 放射疗法 综合治疗 Nasopharyngeal neoplasms Radiotherapy Drug therapy Combined therapy
  • 相关文献

参考文献9

二级参考文献33

  • 1谢聪颖,吴式,张萍.紫杉醇联合草酸铂治疗复治晚期非小细胞肺癌的疗效[J].癌症,2004,23(8):947-950. 被引量:16
  • 2张万团,张恩罴,周兰荪,李凤岩.联合化疗和放射治疗局部晚期鼻咽癌的临床研究[J].癌症,1996,15(1):54-56. 被引量:12
  • 3Henderson IC, Berry DA, Demetri GD, et al. Improved outcomes from adding sequential Paclitaxel but not from escalating Doxonabicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol, 2003,21 : 963-964.
  • 4Gori S, Mosconi AM, Basurtol C, et al. Weekly paclitaxel in metastatic breast cancer patients: a phase Ⅱ study. Tumori,2002,88:470-473.
  • 5Michaud LB, Valero V, Hortobagyi G. Risks and benefits of taxanxes in breast and ovarian cancer. Drug Safety, 2000,23:401-428.
  • 6Miller AB, Hoogstraten B, Staquet M, et al. Reporting results of cancer treatment. Cancer, 1981,47:207-214.
  • 7Bonadonna G, Valagussa P. Comment on "The methodologic dilemma in retrospectively correlating the amount of chemotherapy received in adjuvant therapy protocols with disease-free survival". Cancer Treat Rep, 1983,67 : 527-529.
  • 8Seidman AD, Tiersten C, Hudis C, et al. Phase Ⅱ trim of paxlitaxel by 3-hour infusion as initial mad salvage chemotherapy for metastatic breast cancer. J Clin oncol, 1995,13:2575-2581.
  • 9Winer EP, Berry DA, Woolf S, et al. Failure of higher-dose paclitaxel to improve outcome in patients with metastatic breast cancer: cancer and leukemia group B trial 9342. J Clin Oncol, 2004, 22:2061-2168.
  • 10Citron ML, Berry DA, Cirfincione C, et al. Randomized trim of dosedense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol, 2003, 21:1431-1439.

共引文献105

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部