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目的研究多西紫杉醇/氟尿嘧啶联合顺铂同步放疗治疗局部晚期鼻咽癌近期疗效及安全性。方法60例局部晚期鼻咽癌患者随机分为观察组(TP组)和对照组(PF组),每组30例。观察组采用多西紫杉醇(TXT)75mg/m2静滴d1;DDP 25mg/m2 d1~3静滴;对照组5-Fu 500mg/m2,静滴,d1~5;DDP25mg/m2 d1-3静滴;21d为1周期;共2个周期。放疗均采用3D-CRT,靶区剂量67~70Gy/7周。根据RECIST1.1版的标准评价肿瘤近期治疗效果并计算有效率(RR)。按照美国国立癌症研究所通用毒性标准NCI-CTC3.0评价不良反应。结果 60例中57例患者均可评价疗效。有效率(RR):TP组93.10%,PF组96.42%,二组RR差异无统计学意义(P>0.05)。二组主要毒副反应包括骨髓抑制、肝功能损害、胃肠道反应和口腔黏膜炎。胃肠道反应和口腔黏膜炎的发生率PF组明显高于TP组(P<0.05)。结论多西紫杉醇联合顺铂同步放疗治疗晚期鼻咽癌的近期疗效肯定,毒副反应较轻,患者大多可耐受,可作为治疗晚期鼻咽癌的选择。
Objective To study the short-term efficacy and safety of docetaxel / fluorouracil combined with cisplatin in the treatment of locally advanced nasopharyngeal carcinoma. Methods Sixty patients with locally advanced nasopharyngeal carcinoma were randomly divided into observation group (TP group) and control group (PF group), 30 cases in each group. The observation group received docetaxel (TXT) 75mg / m2 intravenous d1; DDP 25mg / m2 d1 ~ 3 intravenous drip; control group 5-Fu 500mg / m2, intravenous drip, d1 ~ 5; DDP25mg / m2 d1-3 intravenous infusion ; 21d for a cycle; a total of 2 cycles. Radiotherapy using 3D-CRT, the target dose of 67 ~ 70Gy / 7 weeks. RECIST1.1 version of the standard evaluation of the recent treatment of tumors and calculate the effective rate (RR). Adverse reactions were evaluated according to the National Institutes of Health NCI-CTC 3.0 standard. Results 60 patients in 57 patients can evaluate the efficacy. The effective rate (RR) was 93.10% in the TP group and 96.42% in the PF group, with no significant difference between the two groups (P> 0.05). The two major toxicities include myelosuppression, impaired liver function, gastrointestinal reactions and oral mucositis. The incidence of gastrointestinal reactions and oral mucositis in PF group was significantly higher than that in TP group (P <0.05). Conclusions Docetaxel and cisplatin combined with concurrent radiotherapy in the treatment of advanced nasopharyngeal carcinoma have the positive curative effect in the near future. The toxicities and side effects are mild and most of them are tolerable. They may be used as the treatment for advanced nasopharyngeal carcinoma.