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补充锌对接受同步放化疗的晚期鼻咽癌患者生存的影响:一项双盲随机研究的随访及亚组分析

Effects of zinc supplementation on the survival of patients who received concomitant chemotherapy and radiotherapy for advanced nasopharyngeal carcinoma: follow-up of a double-blind randomized study with subgroup analysis.

作者信息

Lin Yung-Song, Lin Li-Ching, Lin Shih-Wei

机构信息

Department of Otolaryngology, Taipei Medical University, Chi Mei Medical Center, Yung Kan City, Tainan County, Taiwan.

出版信息

Laryngoscope. 2009 Jul;119(7):1348-52. doi: 10.1002/lary.20524.

DOI:10.1002/lary.20524
PMID:19402154
Abstract

OBJECTIVES/HYPOTHESIS: Dietary zinc has been reported to have positive effects on treating carcinoma. This study examined the effects of zinc supplementation on the improved survival of patients with advanced nasopharyngeal carcinoma receiving concomitant chemotherapy and radiotherapy (CCRT).

STUDY DESIGN

A double-blind, placebo-controlled clinical study with subgroup analysis.

METHODS

Thirty-four patients with stages III and IV nasopharyngeal carcinoma were selected from a double-blind, placebo-controlled clinical study. All the patients were randomized to receive a standard dose (75 mg/day for 2 months) of zinc supplements or placebo, in conjunction with CCRT. The overall local recurrence, metastasis, and disease-free survivals were defined as the period between the time of first treatment to the time of death, local recurrence, or distant metastases occurred.

RESULTS

Patients in the experimental group exhibited a higher 5-year overall local-free and disease-free survival rate than the patients in the placebo group (P = .044, P = .007, and P = .033, respectively). However, no significant differences were found between both patient groups for the 5-year metastases-free survival rate (P = .149).

CONCLUSIONS

Zinc supplementation prescribed in conjunction with CCRT effects attenuating local tumor recurrence and improves the overall survival of patients with advanced nasopharyngeal carcinoma. The failure to reduce distant metastasis survival might have been related in part to the more advanced disease stages in our patients.

摘要

目的/假设:据报道,膳食锌对治疗癌症有积极作用。本研究探讨了补充锌对晚期鼻咽癌患者同步放化疗(CCRT)后生存率提高的影响。

研究设计

一项进行亚组分析的双盲、安慰剂对照临床研究。

方法

从一项双盲、安慰剂对照临床研究中选取34例III期和IV期鼻咽癌患者。所有患者随机接受标准剂量(75毫克/天,共2个月)的锌补充剂或安慰剂,并结合CCRT。总体局部复发、转移和无病生存期定义为从首次治疗到死亡、局部复发或远处转移发生的时间段。

结果

实验组患者的5年总体局部无病生存率和无病生存率高于安慰剂组患者(分别为P = 0.044、P = 0.007和P = 0.033)。然而,两组患者的5年无转移生存率无显著差异(P = 0.149)。

结论

CCRT联合补充锌可减少局部肿瘤复发,提高晚期鼻咽癌患者的总体生存率。未能降低远处转移生存率可能部分与我们患者中疾病分期更晚有关。

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