Tao Youmao, Ma Chong, Yin Xiangdang, Fang Xuedong, Liu Lixiu
Youmao Tao, China-Japan Union Hospital, Jilin University, Changchun 130033, China.
Chong Ma, China-Japan Union Hospital, Jilin University, Changchun 130033, China.
Pak J Med Sci. 2016 Sep-Oct;32(5):1126-1130. doi: 10.12669/pjms.325.10640.
To explore the therapeutic effects of sequential chemoradiotherapy with pemetrexed and cisplatin on locally advanced laryngeal cancer (LALC).
Fifty LALC patients who were treated in our hospital between January 2010 and January 2012 were selected and randomly divided into an observation group and a control group (n=25). The two groups were given conventional radiotherapy in the same manner, before which two cycles of chemotherapy were performed. The observation group intravenously infused with 500 mg/m pemetrexed on d1 and 25 mg/m cisplatin on d1-3, with 28 days as a cycle. The control group was intravenously infused with 25 mg/m cisplatin on d1-3 and 400 mg/m fluorouracil, with 28 days as a cycle. The short-term effects and adverse reactions of both groups were observed after treatment, and their survival was observed by follow-up for five years.
The response rate was 84% (21/25) in the observation group and 64% (16/25) in the control group, between which the difference was statistically significant (P<0.05). The differences in the incidence rates of short-term adverse reactions such as grade III-IV gastrointestinal reactions and bone marrow suppression were not statistically significant between PC regimen (pemetrexed combined with cisplatin) and PF regimen (cisplatin combined with fluorouracil) (P>0.05). The incidence of long-term adverse reactions such as grade III-IV laryngeal edemas, laryngeal cartilage inflammation and laryngeal cartilage necrosis showed no significant differences between the two groups (P>0.05). The median survival was 3.3 years after PC chemotherapy and 2.8 years after PF chemotherapy, between which the difference was not statistically significant (P>0.05). The levels of serum tumor markers significantly decreased after PC and PF treatments compared with those before (P<0.05).
Combining PC chemotherapy with radiotherapy has satisfactory short-term therapeutic effects on LALC, and the resulting adverse effects can be tolerated. Therefore, this strategy is worthy of promotion and application in clinical practice.
探讨培美曲塞联合顺铂序贯放化疗对局部晚期喉癌（LALC）的治疗效果。
选取2010年1月至2012年1月在我院治疗的50例LALC患者，随机分为观察组和对照组（n = 25）。两组均以相同方式给予常规放疗，放疗前均进行两个周期的化疗。观察组在第1天静脉输注500mg/m²培美曲塞，第1 - 3天静脉输注25mg/m²顺铂，28天为一个周期。对照组在第1 - 3天静脉输注25mg/m²顺铂和400mg/m²氟尿嘧啶，28天为一个周期。治疗后观察两组的近期疗效及不良反应，并随访5年观察其生存情况。
观察组有效率为84%（21/25），对照组为64%（16/25），两组差异有统计学意义（P<0.05）。培美曲塞联合顺铂（PC方案）与顺铂联合氟尿嘧啶（PF方案）相比，Ⅲ - Ⅳ级胃肠道反应、骨髓抑制等近期不良反应发生率差异无统计学意义（P>0.05）。两组Ⅲ - Ⅳ级喉水肿、喉软骨炎、喉软骨坏死等远期不良反应发生率差异无统计学意义（P>0.05）。PC化疗后中位生存期为3.3年，PF化疗后为2.8年，差异无统计学意义（P>0.05）。PC和PF治疗后血清肿瘤标志物水平较治疗前均显著降低（P<0.05）。
PC化疗联合放疗对LALC有满意的近期治疗效果，且不良反应可耐受。因此，该方案值得在临床实践中推广应用。
