奈达铂联合调强放疗对局部晚期鼻咽癌的疗效的作用分析

目的：分析奈达铂联合强调放疗在局部晚期鼻咽癌患者中的疗效。方法：选择我院局部晚期鼻咽癌患者87 例，随机分为两个组，分别是奈达铂组（A组）和顺铂组（B组），对两组患者接受治疗后的近期疗效、远期疗效以及毒性反应进行比较分析。结果：A、B两组患者鼻咽原发灶完全缓解（CR）率分别为91.8%、86.8%（P=0.632〉0.05），颈部淋巴结转移灶的完全缓解（CR）率分别为87.8%、84.2%（P=0.864〉0.05），均不存在统计学显著性差异。A、B 两组患者3 年的总生存率（OS）分别为：81.6%、78.9%，P=0.762；局部控制率（LC）分别为：93.9%、94.7%，P=0.890；两组患者3 年的区域控制率（RC）分别为：98.0%、97.3%，P=0.849；两组患者3年的无远处转移生存率（DMFS）分别为：79.6%、76.3%，P= 0.724。A 组患者Plt 下降发生率为46.9%显著高于B 组发生率34.2%（P〈0.05），具有统计学显著性差异；A 组患者恶心呕吐的发生率36.7%显著低于B 组患者的发生率76.3%（P〈0.05），具有统计学显著性差异；其余毒性反应的发生率均不存在统计学显著性差异（P〉0.05）。结论：奈达铂联合强调放疗治疗局部晚期鼻咽癌的近期疗效与远期疗效与顺铂相当，但是奈达铂胃肠道不良反应发生率较顺铂低，血小板的降低程度比顺铂更加严重。

Effect Analysis of Nedaplatin Combined IMRT for Locally Advanced Nasopharyngeal Carcinoma

Objective： To analyze the medical effect of intensified radiotherapy combined with nedaplatin on patients with locally advanced nasopharyngeal cancer. Methods： 87 cases with locally advanced nasopharyngeal cancer who were treated in our hospital were selected and randomly divided into two groups. Then the short term curative effect, long term curative effect, and toxic reactions of the patients in the two groups were observed and compared between two groups after treatment. Results： The Complete Re- mission （CR） rates of the nasopharyngeal primary lesion in the patients of Group A and B are respectively 91.8%, 86.8%（p=0.632〉0.05 ）; The Com- plete Remission （CR） rates of the metastases in the patients＇ cervical lymph nodes are respectively 87.8%, 4.2%（p= 0.864〉0.05 ）. All the rates indicate no evidently statistical difference. The Overall Survival （OS） rates within three years of the patients in Group A and Group B are respectively 81.6%, 78.9%, P=0.762; Local Controlling （LC） rates are respectively 93.9%, 94.7%, P=0.890. The Regional Control- ling （RC） rates are respectively 98.0%, 97.3% P=0.849. Distance Metastasis Free Survival （DMFS） rates are respectively 79.6%, 76.3%, P=0.724. The Plt reduction rate of Group A is 46.9%, obviously higher than 34.2%, the reduction rate of Group B （P〈0.05）, which has great statistical difference. Occurrence rate of nausea and vomiting in Group A is 36.7%, obviously lower than 76.3%, the occurrence rate of nausea and vomiting in Group B（P〈0.05 ）, which has great statistical difference; the occurrence rates of toxic reaction have no big statistical difference （P〉0.05）. Conclusion： Nedaplatin combined with radiotherapy for locally advanced nasopharyngeal emphasize short-term efficacy and long-term efficacy with cisplatin quite, but nedaplatin incidence of gastrointestinal adverse reactions compared with cisplatin low platelet levels decreased more than cisplatin severe.