| 罗秀玲,金风,毕婷,吴伟莉,李媛媛,龙金华,陈国焱,何志旭,周建奖,余芳.TPF方案诱导化疗不同给药方式联合调强放疗治疗局部晚期鼻咽癌的中期疗效及预后分析[J].中华放射医学与防护杂志,2018,38(8):595-601 |
| TPF方案诱导化疗不同给药方式联合调强放疗治疗局部晚期鼻咽癌的中期疗效及预后分析 |
| Mid-term efficacy and prognosis of TPF regimen induction chemotherapy combined with IMRT for locally advanced nasopharyngeal carcinoma |
| 投稿时间：2017-09-26 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.08.007 |
| 中文关键词: 鼻咽癌 时间调节化疗 调强放疗 中期疗效 淋巴细胞免疫功能 |
| 英文关键词:Nasopharyngeal carcinoma Time-adjusted chemotherapy Intensity-modulated radiation therapy Mid-term outcomes Lymphocyte immune function |
| 基金项目:国家自然科学基金（11375164） |
| 作者 | 单位 | E-mail | | 罗秀玲 | 550004 贵阳, 贵州医科大学附属医院头颈肿瘤科 | | | 金风 | 550004 贵阳, 贵州医科大学附属医院头颈肿瘤科 | jinf8865@yeah.net | | 毕婷 | 550004 贵阳, 贵州医科大学附属医院头颈肿瘤科 | | | 吴伟莉 | 550004 贵阳, 贵州医科大学附属医院头颈肿瘤科 | | | 李媛媛 | 550004 贵阳, 贵州医科大学附属医院头颈肿瘤科 | | | 龙金华 | 550004 贵阳, 贵州医科大学附属医院头颈肿瘤科 | | | 陈国焱 | 550001 贵阳, 贵州医科大学附属肿瘤医院/贵州省肿瘤医院头颈肿瘤科 | | | 何志旭 | 550004 贵阳, 贵州医科大学 | | | 周建奖 | 550004 贵阳, 贵州医科大学 | | | 余芳 | 550004 贵阳, 贵州医科大学 | |
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| 中文摘要: |
| 目的 探讨时间调节化疗联合调强放疗与常规化疗联合调强放疗对局部晚期初治鼻咽癌患者疗效、不良反应和免疫功能的影响。方法 采用随机数表分组法进行前瞻性研究，将本科收治的局部晚期初治鼻咽癌患者66例分为2组，即时辰组36例和常规组30例。两组均采用多西他赛+顺铂+氟尿嘧啶方案诱导化疗2周期，时辰组采用电子化疗全自动注药泵静脉输入给药，常规组采用常规静脉输液，两组均采用同步顺铂联合调强放射治疗。根据Kaplan-Meier法计算生存率和CTC3.0标准评价远期不良反应。结果 时辰组和常规组3年的总生存率（OS）分别为86.1%和93.3%，3年的无进展生存（PFS）分别为83.3%和93.3%，3年的无复发生存（RFS）分别为88.5%和93.3%，3年的无远处转移生存（DMFS）分别为94.1%和100%，差异均无统计学意义（P>0.05）。时辰组口干及听力下降较常规组有降低趋势。时辰组CD3+、CD3+CD4+、CD3+CD4+CD8+、CD4+/CD8+较常规组有升高趋势。结论 时间调节化疗联合调强放疗与常规化疗联合调强放疗相比，两组中期疗效相当，但前者有降低不良反应，改善患者生活质量，改善患者免疫功能趋势。 |
| 英文摘要: |
| Objective To investigate the efficacy, adverse reactions and immune function of time-adjusted chemotherapy combined with intensity-modulated radiation therapy (IMRT) and conventional chemotherapy combined with IMRT for locally advanced nasopharyngeal carcinoma.Methods Random number grouping method was used to divide 66 cases of locally advanced nasopharyngeal carcinoma into 2 groups, of which 36 cases in the time-adjusted chemotherapy group and 30 cases in the conventional group. Both of them received docetaxel + cisplatin + fluorouracil regimen to induce chemotherapy for 2 cycles. The time-adjusted chemotherapy group was treated with intravenous injection of electronic automatic injection pump, the conventional group was treated with conventional intravenous infusion, and both groups were treated with synchronous cisplatin combined with IMRT. Calculated survival rate was generated by Kaplan-Meier method and long-term adverse reactions was evaluated according to CTC 3.0 criteria.Results The 3-year overall survival (OS) rate was 86.1% and 93.3% in the time-adjusted chemotherapy group and the regular group, the 3-year progress-free survival (PFS) was 83.3% and 93.3%, the 3-year RFS was 88.5% and 93.3%, and the 3-year recurrence-free survival was 94.1% and 100% respectively with no statistically significant difference (P>0.05). The dryness and hearing loss of the time-adjusted chemotherapy group had a decreasing trend compared with the conventional group. However, CD3+, CD3+CD4+, CD3+CD4+CD8+, and CD4+/CD8+ of the time-adjusted chemotherapy group had an increasing trend compared with the conventional group. Conclusions Both time-adjusted chemotherapy and conventional chemotherapy combined with IMRT had comparable mid-term efficacy, but the former had lower adverse reactions, improved quality of life and immune function. |
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