【摘要】 目的比较奈达铂(NDP)和顺铂(DDP)每周化学治疗(化疗)方案联合同步放射治疗(放疗)对局部晚期头颈部鳞癌的近期疗效和不良反应。方法局部晚期头颈部鳞癌患者52例,随机分成NDP组和DDP组各26例。NDP组化疗方案:NDP40 mg.(m2)-1静脉滴注,每周1次;DDP组化疗方案:DDP40 mg.(m2)-1静脉滴注,每周1次。两组放疗均采用全程调强放疗方案,原发灶剂量(72～74)Gy/33次;颈部转移淋巴结剂量(66～70)Gy/33次;颈部预防照射剂量(50～56)Gy/28次。结果 NDP组和DDP组有效率分别为92.3%,88.5%(P>0.05);呕吐发生率分别为65.4%,92.3%(P<0.05);中性粒细胞下降发生率分别为73.1%,88.5%(P>0.05);血红蛋白下降发生率分别为65.4%,73.1%(P>0.05);血小板下降发生率分别为92.3%,50.0%(P<0.05)。结论 NDP周方案化疗同步放疗治疗局部晚期头颈部鳞癌的近期疗效与DDP相近,但NDP胃肠道不良反应较少,患者耐受性较好。更多还原

【Abstract】 Objective To study the efficacy and toxicity of concurrent chemotherapy[nedaplatin(NDP) and cisplatin(DDP)] and radiotherapy in the treatment of local-advanced head and neck squamous carcinoma.Methods A total of 52 patients with local-advanced head and neck squamous carcinoma were randomized into NDP group(n=26) and the DDP group(n=26).The two groups of patients received five courses of chemotherapy during their radiotherapy.Chemotherapy regimens were as follows: NDP 40 mg·(m2)-1 once a week and DDP 40 mg·(m2)-1 once a week.Radiotherapy was as follow: all patients received intensity modulated radiation therapy(IMRT).The doses of radiation on primary tumor and lymphatic gland were(72-74) Gy/33f and(66-70) Gy/33f,respectively.The prophylactic dose of neck was(50-56) Gy/28f.Results The effective rate of NDP and DDP was 92.3% and 88.5%,respectively(P>0.05).Vomiting rate was significantly lower in NDP group(65.4%) than DDP group(92.3%)(P<0.05).There was no significant difference between the two groups in the incidence of leukopenia(73.1% vs.88.5%) and reaction rate of hemoglopenia(65.4% vs.73.1%).There was a significantly higher incidence rate of thrombocytopenia in NDP group(92.3%) than in DDP group(50.0%)(P<0.05).Conclusion There is no significant difference between NDP and DDP regimens,and the NDP group has a lower digestive reaction rate than DDP group.The main adverse reaction of NDP regimens is myelosuppression,especially thrombocytopenia.更多还原