| Objective:To observe and compare the incidence and intensity of toxic reaction and side effects,changes in immune function and short-term efficacy between chrono-chemotherapy with radiotherapy(CCR)and routine-chemotherapy with radiotherapy(RCR),both of which were combined with intensity-modulated radiation therapy,in the treatment of locally advanced nasopharyngeal carcinoma.The aim of this study was to reduce the incidence of treatment related adverse events and to find a new application model for the traditional chemotherapeutic drugs.Methods:114 patients with locally advanced nasopharyngeal carcinoma who received initial treatment were divided into two groups:CCR group(57 cases)and RCR group(57 cases).CCR group:Docetaxel(DOC)75mg/m2,ivgtt,d1(03:30～04::30);Cisplatin(DDP)75mg/m2,civ,dl-d5(10:00-22:00);5-fluorouracil(5-FU)750mg/m2/d1,pump injection,dl-d5(22:00～10:00).Concurrent chemotherapy:DDP 100mg/m2,civ,dl(10:00-22:00).RCR group:DOC 75mg/m2,ivgtt,dl;DDP 75mg/m2,ivgtt,first day;5-FU 750mg/m2/d1,civ,dl-d5(continued pump for 120 hours).Concurrent chemotherapy:DDP 100mg/m2,ivgtt,dl.Two groups were applied with IMRT,6MV-X,Dose:T1-2 GTVnx 69.96 Gy/33f;T3-4 GTVnx 73.92Gy/33f,PTVnx 69.96Gy/33f,PGTVnd 69.96Gy/33f,PTV160.06Gy/33f,PTV2 50.96Gy/28f,1f/d,5f/w.The immediate efficacy evaluation was performed with Recisit 1.1 after radiation therapy to measure the lesion retraction.The adverse events during the treatment was evaluated according to the CTC 3.0 assessment.PASW statistics 22.0 software was used for data input and result analysis.Results:No statistical significance was found in constituent ratio of immediate efficacy evaluation CR、PR、SD、PD between CCR group and RCR group(P>0.05).There was no statistical significance in the effective rate between two groups(P>0.05).The white blood cell count,neutrophil count,vomiting,oral mucositis significantly reduced in CCR group compared with RCR group(P<0.05).After concurrent chemoradiotherapy,CD3+,CD4+/8+T cell in CCR group had statistical significance in comparison with RCR group(P<0.05).Conclusion:As a new treatment model,CCR combined with IMRT can reduce the incidence and intensity of treatment-related side effects without decreasing the clinical efficacy,and improve the immune functions deserving the clinical promotion and application. |
