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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (11): 131-134.

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紫杉醇与甘氨双唑钠在局部晚期鼻咽癌放疗中的增敏作用比较

赖振南,梁荣,谢忠,黄杰   

  1. 广东医学院附属医院肿瘤科, 广东 湛江 524001
  • 收稿日期:2011-05-24 出版日期:2011-11-10 发布日期:2011-11-10
  • 作者简介:赖振南,男,副主任医师,主要从事肿瘤放疗专业的研究。

Radio-sensitization effect of paclitaxel versus sodium glycididazole for local advanced nasopharyngeal carcinoma

LAI Zhen-nan, LIANG Rong, XIE Zhong, HUANG Jie   

  1. Department of Oncology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, Guangdong, China
  • Received:2011-05-24 Online:2011-11-10 Published:2011-11-10

摘要:

目的   比较紫杉醇(PTX)与甘氨双唑钠(CMNa)在鼻咽癌放疗中的增敏作用和不良反应。方法   首程治疗的82例鼻咽癌患者,随机分为紫杉醇增敏组(PTX组)和甘氨双唑钠增敏组(CMNa组),在全程放疗中PTX组给予PTX 60mg/m2静脉滴注(先给予地塞米松常规预处理),1次/10d,共5次。CMNa组于每周1、3、5放疗前静脉滴注CMNa 0.75~1.0g,连用7周。采用热塑面罩固定、低熔点挡铅的常规放疗方法放疗。结果   放疗结束时及放疗后3个月2组患者的鼻咽部病灶及颈部转移病灶完全消退率均无明显差异。随诊5~50个月(中位20个月),PTX组的远处转移率(28.6%)低于CMNa组(50.0%),差异有统计学意义(P<0.05)。PTX组鼻咽及颈部复发率低于CMNa组,但差异无统计学意义(P>0.05)。PTX组2、3级口腔黏膜炎、白细胞减少较CMNa组明显,差异有统计学意义(P<0.01)。结论   在放疗中加入低剂量PTX对局部晚期鼻咽癌的增敏作用与CMNa相当。前者能减少远处转移的发生,但增加了急性不良反应,特别是口腔黏膜炎和白细胞减少。

关键词: 鼻咽肿瘤;放射治疗;紫杉醇;甘氨双唑钠;放射增敏

Abstract:

 Objective   To evaluate the radio-sensitization effect and side effect of  paclitaxel (PTX) versus sodium glycididazole (CMNa) in local advanced nasopharyngeal carcinoma. Methods   82 patients were randomly divided into the PTX group (n=42) and the CMNa group (n=40). The PTX group was received 60 mg/m2 of  PTX via intravenous infusion, every 10 days for 5 times in the radiotherapy duration. The CMNa group received injections of CMNa at a dose of 0.75-1.0g before the radiotherapy  3 times per week for 7 weeks. All patients received conventional fractionation radiotherapy. Results   There was no significant difference in complete tumor remission between the two groups at the end of the therapy and 3 months after  radiotherapy. The median follow-up times was 20 months. The metastasis rate in the PTX group (28.6%) was significantly lower than in the CMNa group (50.0%) (P<0.05). The regional recurrence rate was lower in the PTX group than in the CMNa group, but there was no significant difference(P>0.05). Oral cavity mucositis in grades 2 and 3 and leukopenia in the PTX group were more frequent than in the CMNa group (P<0.01). Conclusion   Small dose paclitaxel was similar to  CMNa in radio-sensitization efficiency for local advanced nasopharyngeal carcinoma, and paclitaxel plus radiotherapy could reduce metastasis, but increase some acute toxicities, especially in oral cavity mucositis and leukopenia.

Key words: Nasopharyngeal neoplasms; Radiotherapy; Paclitaxel; Sodium glycididazole; Radiosensitivity

中图分类号: 

  • R739.63
[1] 邱晨1,杨宁2,田光亮1,刘慧忠1. 鼻咽癌患者放疗前后营养状况的前瞻性研究[J]. 山东大学学报(医学版), 2011, 49(6): 130-133.
[2] 黄方 康瑞 吴春林. VEGFC、NF-κBp65及Survivin在鼻咽癌中的表达及临床意义[J]. 山东大学学报(医学版), 2209, 47(6): 83-.
[3] 黄方 康瑞 吴春林. VEGFC、NF-κBp65及Survivin在鼻咽癌中的表达及临床意义[J]. 山东大学学报(医学版), 2009, 47(6): 83-.
[4] 邹纪东1,徐伟1,吕正华1,曹洪源1,王海波1,栾信庸2. 下咽癌中maspin表达与血管生成和淋巴管生成的相关性[J]. 山东大学学报(医学版), 2010, 48(12): 82-.
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