放疗联合顺铂不同剂量方案同期化疗治疗鼻咽癌的耐受性研究

发布时间：2018-03-30 06:49

本文选题：鼻咽癌　切入点：放射治疗　出处：《广西医科大学》2011年硕士论文

【摘要】：目的:评价放疗联合顺铂不同剂量方案同期化疗治疗鼻咽癌的急性毒副反应及近期疗效。方法:从2010年3月至2010年10月共160例患者进入本研究,根据顺铂使用方案不同采用随机数字表法分为八个组(A组:DDP100mg/m~2,1天用,q4w;B组:100mg/m~2,分3天用;q4w;C组:DDP80mg/m~2,1天用,q4w;D组:DDP80mg/m~2,分3天用,q4w;E组:DDP100mg/m~2,1天用,q3w;F组:DDP100mg/m~2,分3天用,q3w;G组:DDP80mg/m~2,1天用,q3w;H组:DDP80mg/m~2,分3天用,q3w;共2周期)。所有入组患者均接受根治性放疗方案,放疗技术采用调强放疗(IMRT)或常规放疗(CRT),鼻咽部原发灶剂量68-78Gy,颈部转移灶剂量62-78Gy,颈部预防剂量54-56Gy。同期化疗按所在组要求采用单药顺铂化疗。详细记录及评价治疗过程出现的各种毒副反应,并积极处理。放疗结束时复查鼻咽镜、鼻咽及颈部CT或MRI,行疗效评价。结果:各组病例在一般临床资料方面具有可比性。各组的急性毒副反应发生率无显著差异,所有的并发症经对症支持治疗后均能恢复。在治疗依从性方面,3例(D、G、H组各1例)患者出现放疗中断;有5例患者未完成第二周期化疗(A组:3例,D组:1例,G组:1例),行Logistic回归分析结果显示女性患者白细胞下降发生率明显高于男性患者(P=0.012),而年龄、病理类型、临床分期及放疗技术对各毒副反应的发生均无显著相关性。近期疗效方面,各组患者均得到有效缓解。结论:顺铂100mg/m~2与80mg/m~2及不同的剂量分割和间隔时间同期化疗治疗鼻咽癌的急性毒副反应发生率及治疗依从性无显著差异,近期疗效相似。
[Abstract]:Objective: to evaluate the acute side effects of radiotherapy combined with cisplatin in the treatment of nasopharyngeal carcinoma (NPC). Methods: from March 2010 to October 2010, 160 patients were enrolled in this study. According to the scheme of cisplatin use, eight groups were randomly divided into eight groups: group A: DDP100mgmmmmmmmm2a, group B: 100mg / mm2; group C: DDP80mgmmmm-2; group C: DDP80mgmmm2a / d; group Q4wD: DDP80mgmmm-2; group DDP100mgmmmmm-2: DDP100mgmmm-1 / 21d; group DDP100mgmmgmm-2 / 2; group DDP100mgmmgmmm-2: DDP100mgmmgmm-2 / 2w / 2w / d, respectively. All patients were treated with radical radiotherapy. The radiotherapy technique was IMRT or CRT, the primary dose of nasopharynx was 68-78 Gy, the dose of cervical metastasis was 62-78 Gy, and the dose of cervical prophylaxis was 54-56 Gy. Chemotherapy at the same time was treated with single drug cisplatin according to the requirements of the group. The treatment was recorded and evaluated in detail. All kinds of toxic and adverse reactions, At the end of radiotherapy, nasopharyngoscope, nasopharynx and neck CT or MRI were reviewed to evaluate the curative effect. Results: the general clinical data were comparable in each group, but there was no significant difference in the incidence of acute toxic side effects in each group. All the complications were recovered after symptomatic support treatment. Logistic regression analysis showed that the incidence of leukopenia in female patients was significantly higher than that in male patients. There was no significant correlation between clinical staging and radiotherapy. Conclusion: there is no significant difference in the incidence of acute side effects and therapeutic compliance between cisplatin 100mg/m~2 and 80mg/m~2, different dose partitioning and interval chemotherapy for nasopharyngeal carcinoma, but the short-term curative effect is similar.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

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