作　　者： ; ; ; ; ; ; ;

机构地区： 广西壮族自治区人民医院

出　　处： 《肿瘤防治研究》 2015年第3期285-289,共5页

摘　　要： 目的比较无远处转移鼻咽癌(nasopharyngeal carcinoma,NPC)调强放疗(intensity-modulated radiotherapy,IMRT)联合单药顺铂每周(40 mg/m2,1次/周)和每3周(80~100 mg/m2,1次/3周)同期放化疗的急性不良反应和治疗前后的营养状况差异。方法回顾分析45例IMRT联合单药顺铂同期化疗的非转移NPC患者临床资料,急性不良反应评估采用CTCAE 3.0标准,不良反应和营养状况统计分析采用t检验、卡方分析或精确概率法以及方差分析检验。结果 45例患者口干、咽痛、口腔黏膜炎、皮炎、恶心、呕吐及骨髓抑制3~4级不良反应发生率分别为6.7%、15.6%、28.9%、6.7%、8.9%、13.3%和22.2%。治疗后BW、BMI、TP、BUN、Cr、Na+、K+、Ca2+和Cl-变化的性别分层方差分析差异均无统计学意义(P>0.05),ALB变化接近统计学意义。组内分析显示两组治疗后ALB、TP、Na+和Cl-均下降(P<0.05),但顺铂每周组BW、BMI下降更明显(P<0.05)。结论治疗前后两组营养状况均有不同程度下降,顺铂每周组营养失衡较顺铂每3周组更普遍,但治疗前后两组变化无明显差异。 Objective To compare the acute toxicities and nutritional status between non-metastasis nasopharyngeal carcinoma(NPC) patients treated by intensity-modulated radiotherapy(IMRT) combined with 40 mg/m2 cisplatin alone concurrent chemotherapy weekly and those treated by IMRT with 80-100 mg/m2 cisplatin every three weeks. Methods A retrospective clinical data analysis was conducted on 45 patients with non-metastatic NPC. Patients received 40 mg/m2 cisplatin weekly or 80-100 mg/m2 cisplatin every three weeks, concurrently with IMRT. The National Cancer Institute Common Toxicity Criteria version 3.0 scale(CTCAE V3.0) was used to assess the chemotherapy and acute toxicities. The acute toxicities and nutritional status were analyzed statistically by t-test, Chi-Square test/Chi-Square Goodness-of-Fit test or Analysis of Variance(ANOVA). Results In 45 NPC patients treated by IMRT, 31 patients received 40 mg/m2 cisplatin weekly and 14 patients received 80-100 mg/m2 cisplatin every three weeks concurrently chemotherapy. The grade 3-4 acute toxicity occurrence rates of xerostomia, pharyngodynia, oral mucositis, dermatitis, nausea, vomit and myelosuppression were 6.7%, 15.6%, 28.9%, 6.7%, 8.9%, 13.3% and 22.2%, respectively. Although the changes of BW, BMI, ALB, TP, BUN, Cr, Na+, K+, Ca2+ and Cl- had no statistical difference between two groups after treatment(P>0.05) by Gender stratification ANOVA, the change of ALB was closed to a statistical difference. Both groups of ALB, TP, Na+ and Cl- were decreased after treatment(P<0.05), but BW and BMI in cisplatin weekly group were decreased more severely than those in cisplatin every three weeks group. Conclusion It seems that the nutritional status of cisplatin weekly group is decreased more generally than that of cisplatin every three weeks group, but without significant difference in two groups before and after treatment.

关 键 词： 鼻咽肿瘤 顺铂 放射疗法 高频 同期放化疗 急性不良反应