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目的:评价比较以奈达铂(NDP)为主的化疗方案与以顺铂(DDP)为主的化疗方案对头颈部鳞癌、食管癌和非小细胞肺癌(nonsmallcelllungcancer,NSCLC)的疗效及不良反应。方法:患者随机分为两组。试验组:头颈部鳞癌及食管癌,NDP联合5氟尿嘧啶(5FU)和四氢叶酸(CF);NSCLCNDP联合诺维本(NVB);对照组:以DDP替代NDP,两组其他用药均相同。所有患者均接受2个周期以上的化疗。结果:2002年5月～2003年11月共有194例患者入组,其中188例完成试验,6例出组。头颈部鳞癌60例,食管癌60例,NSCLC68例。头颈部鳞癌试验组有效率为46.67%,对照组有效率为46.67%,χ2=0.2820,P=1.0000;食管癌试验组有效率为35.48%,对照组有效率为13.79%,χ2=2.4506,P=0.7470;NSCLC试验组有效率为31.43%,对照组有效率为15.15%,χ2=1.4315,P=0.1553。试验组与对照组的不良反应比较,除恶心、呕吐的发生率差异有统计学意义(χ2=3.4124,P=0.0006),前者明显低于后者外,血常规、腹泻、便秘、乏力等不良反应发生率差异均无统计学意义。结论:以NDP为主的联合化疗方案治疗头颈部鳞癌、食管癌、NSCLC疗效肯定,不良反应中呕吐明显减少,轻中度骨髓抑制,其余不良反应可以耐受。
OBJECTIVE: To evaluate the efficacy and adverse effects of NDP-based chemotherapy and cisplatin-based chemotherapy on head and neck squamous cell carcinoma, esophageal and non-small cell lung cancer (NSCLC) reaction. Methods: Patients were randomly divided into two groups. The experimental group: head and neck squamous cell carcinoma and esophageal cancer, NDP combined with 5 fluorouracil (5FU) and tetrahydrofolate (CF); NSCLCNDP with NVB; control group: DDP instead of NDP, the other two groups were the same medication . All patients received more than 2 cycles of chemotherapy. Results: From May 2002 to November 2003, a total of 194 patients were enrolled, 188 of whom completed the trial and 6 were out of the group. Head and neck squamous cell carcinoma in 60 cases, 60 cases of esophageal cancer, NSCLC68 cases. The effective rate of head and neck squamous cell carcinoma in experimental group was 46.67%, that of control group was 46.67%, χ2 = 0.2820, P = 1.0000; the effective rate of esophageal cancer experimental group was 35.48%, that of control group was 13.79%, χ2 = 2.4506 , P = 0.7470; The effective rate of NSCLC test group was 31.43%, the control group was 15.15%, χ2 = 1.4315, P = 0.1553. The incidence of nausea and vomiting was significantly different between the experimental group and the control group (χ2 = 3.4124, P = 0.0006), the former was significantly lower than the latter, blood, diarrhea, constipation, fatigue and other adverse reactions There was no significant difference in the incidence of response. CONCLUSIONS: NDP-based combination chemotherapy regimen treats squamous cell carcinoma of the head and neck, esophageal cancer and NSCLC with positive curative effect. Vomiting in adverse reactions is significantly reduced. Mild to moderate myelosuppression is achieved and the remaining adverse reactions are tolerable.