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目的研究甘氨双唑钠(CMNa)对中晚期鼻咽癌的放射增敏作用以及不良反应。方法将48例确诊T2～3N2～3M0鼻咽癌患者随机分为研究组和单放组,每组24例。研究组CMNa800mg/m2,用09%生理盐水100ml稀释溶解后静脉输入,30min滴完,输入结束后60min内进行放射治疗,每周3次,从放疗开始连续用药至放疗结束,6～7周。单放组放疗方案同研究组。60Co体外常规放射治疗,鼻咽部DT(68～72)Gy·(34～36)次-1·(6～7)周-1,颈转移淋巴结DT(68～72)Gy·(34～36)次-1·(6～7)周-1,颈部预防量DT56Gy·28次-1·(5～6)周-1。结果鼻咽癌原发灶和颈淋巴结转移灶达完全缓解时放射增敏比(SER)分别为126和120(P<005)。研究组和单放组鼻咽癌原发灶CR分别为917%(22/24)、583%(14/24),P<001;颈淋巴结转移灶CR分别为875%(21/24)、542%(13/24),P<005。研究组和单放组鼻咽癌原发灶体积>50cm3时CR分别为875%(7/8)、333%(3/9),P<005;颈淋巴结转移灶体积>300cm3时CR分别为778%(7/9)、30%(3/10),P<005。两组未发现严重毒性反应。结论CMNa可以增加鼻咽癌原发灶及颈淋巴结转移灶的放射增敏比,对肿瘤体积较大者其放射增敏作用较明显;放疗合并使用CMNa可以提高中晚期鼻咽癌近期疗效,无严重不良反应。
Objective To study the radiosensitization effect and adverse reactions of glycididazole sodium (CMNa) on advanced nasopharyngeal carcinoma. Methods 48 cases of diagnosed T2 ~ 3N2 ~ 3M0 nasopharyngeal carcinoma were randomly divided into study group and radiotherapy group, 24 cases in each group. The study group CMNa800mg / m2, with 09% saline diluted 100ml after intravenous infusion, 30min drip finished, within 60min after the end of the input radiation therapy, three times a week, starting from the beginning of radiotherapy to the end of radiotherapy, 6 to 7 weeks. Radiotherapy group radiotherapy program with the study group. (60-72) Gy · (34-36) · -1.6 (6-7) weeks -1 in nasopharynx and 60-72 Gy · (34-36) cases of cervical lymph node metastasis ) Times -1 (6 to 7) weeks -1, neck prophylaxis DT56Gy 28 times -1 (5 to 6) weeks -1. Results The radiosensitization ratio (SER) was 126 and 120 (P <005) respectively for complete remission of primary and cervical lymph node metastases of nasopharyngeal carcinoma. The CR of primary nasopharyngeal carcinoma was 917% (22/24) and 583% (14/24) respectively in study group and single group, P <0.001. The CR of cervical lymph node metastasis was 875% (21/24) 542% (13/24), P <005. The CR of study group and radiotherapy group were 875% (7/8), 333% (3/9), P <005 respectively when the primary tumor size was> 50cm3 in NPC and CR> 778% (7/9), 30% (3/10), P <005. Two groups did not find serious toxicity. Conclusion CMNa can increase the radio-sensitization ratio of primary and cervical lymph node metastases of nasopharyngeal carcinoma and its radiosensitization effect is more obvious when the tumor volume is larger. The combination of CMNa and radiotherapy can improve the short-term effect of nasopharyngeal carcinoma in the late stage, Serious adverse reactions.