论文部分内容阅读
目的观察时辰化学疗法联合放射治疗对比常规化学疗法联合放射治疗对鼻咽癌的近期疗效及其不良反应。方法 2006年2月2010年3月经病理学证实未接受过化学疗法的38例晚期鼻咽癌患者随机分为常规化学疗法联合放射治疗组(A组,n=20)和时辰化学疗法联合放射治疗组(B组,n=18)。两组均采用常规二维放射治疗。A组化学疗法方案为顺铂(DDP)80 mg/m2,采用完全水化方案,第1天静脉滴注;氟尿嘧啶800 mg/(m2.d),第2~6天120 h连续静脉滴注。B组时辰化学疗法采用Melodies多通道编程输液泵进行正弦曲线式时间调节给药。两组均为DDP 80 mg/m2,于10:00~22:00给药,浓度高峰设定在16:00;氟尿嘧啶800 mg/m2,于22:00~次日10:00给药,浓度高峰设定在凌晨4:00。每21天重复1次,行2~6疗程。结果 A组3程化学疗法后有效率(PR)为95%(19/20),全程结束完全缓解率(complete remission,CR)达75%(15/20);B组在2程化学疗法后PR达100%,全程治疗结束CR达94.4%(17/18)。两组不良反应主要为迟发性血小板减少,发生率分别为35%(7/20)和22.2%(4/18),其他不良反应两组间无明显差别。结论时辰化学疗法联合放射治疗对晚期鼻咽癌在减轻化学疗法造成的血小板减少方面有明显的优势,值得临床推广应用以及进一步发掘时辰化学疗法在临床治疗的价值。
Objective To observe the short-term curative effect and adverse reaction of chrono-chemotherapy combined with radiotherapy versus conventional chemotherapy combined with radiotherapy on nasopharyngeal carcinoma. METHODS: Thirty-eight patients with advanced nasopharyngeal carcinoma who had not received chemotherapy were enrolled in this study. The patients were randomly divided into conventional chemotherapy combined with radiotherapy (group A, n = 20) and chemoradiotherapy combined with radiotherapy Group (Group B, n = 18). Two groups were using conventional two-dimensional radiotherapy. Group A chemotherapy regimen consisted of cisplatin (DDP) 80 mg / m2, complete hydration regimen, intravenous drip on day 1, fluorouracil 800 mg / (m2.d), continuous intravenous drip on day 120 . Group B chemoradiation using Melodies multi-channel programming infusion pump for sinusoidal time-adjusted administration. Both groups were treated with DDP 80 mg / m2, administered at 10: 00-22: 00, the peak concentration was set at 16:00, and fluorouracil 800 mg / m2 at 10:00 on the following day. The concentration The peak is set at 4:00 in the morning. Repeat once every 21 days, line 2 to 6 courses. Results After 3 cycles of chemotherapy in group A, the effective rate (PR) was 95% (19/20) and the complete remission (CR) reached 75% (15/20) in group B. In group B, after 2 cycles of chemotherapy PR up to 100%, the end of the treatment of CR reached 94.4% (17/18). The two groups of adverse reactions are mainly delayed thrombocytopenia, the incidence was 35% (7/20) and 22.2% (4/18), other adverse reactions no significant difference between the two groups. Conclusion Time chemotherapy combined with radiotherapy for advanced nasopharyngeal carcinoma in reducing chemotherapy-induced thrombocytopenia has obvious advantages, it is worthy of clinical application and further explore the value of time chemotherapy in clinical treatment.