替吉奥在一线化疗后晚期鼻咽癌患者维持治疗中的疗效观察

The clinical effects of S-1 on the maintenance therapy of advanced nasopharyngeal carcinoma patients after first-line treatment

目的:探讨替吉奥在晚期鼻咽癌患者一线治疗后的维持治疗中的疗效。方法:选取2012年1月至2014年12月我院收治的58例晚期鼻咽癌患者,以上患者在一线姑息化疗4~6个疗程中获得完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)。观察组30例患者给予替吉奥维持治疗;对照组28例患者以临床观察为主。观察和比较两组患者的客观有效率、不良反应、无进展生存时间及中位生存时间。结果:观察组的客观有效率为80.0%,显著高于对照组(35.7%),差异具有统计学意义(P<0.05)。对照组无疾病进展生存期为4.8个月(95%置信区间为3.8~5.8个月),中位生存期为12.3个月(95%置信区间为8.7~15.9个月);观察组无疾病进展生存期为9.6个月(95%置信区间为8.5~10.7个月),中位生存期为18.8个月(95%置信区间为15.7~21.9个月),均显著长于对照组(P均<0.05)。观察组患者白细胞减少、胃肠道反应、口腔黏膜反应的发生率均显著高于对照组,差异有统计学意义(P均<0.05),但患者能耐受。结论:晚期鼻咽癌患者在一线治疗结束后给予替吉奥维持治疗,能够有效地延长患者的生存时间,提高疗效,不良反应可耐受,值得临床进一步研究。

Objective: To investigate the curative effects of S-1 on the maintenance therapy after first-line treatment of patients with advanced nasopharyngeal carcinoma. Methods: We selected 58 cases of patients with advanced nasopharyngeal carcinoma admitted in our hospital from January 2012 to December 2014. All the patients had first-line treatment for 4 ~ 6 cycles and get CR,PR,SD. Then they were divided into the observation group and control group. Patients in observation group were treated with S-1,and those in control group did not have S-1 treatment.The overall survival time( OS),progression free survival time( PFS),total efficacy as well as incidence of adverse reactions were observed and compared between the two groups. Results: The objective response rates( RR) in the observation group and the control group were 80. 0% and 35. 7%,respectively. The control group had the progression-free survival time of 4. 8 months[95 % confidence interval( CI) of 3. 8 ~ 5. 8 months] and the median survival time of 12. 3 months( 95% CI of 8. 7 ~ 15. 9 months). The observation group had the progression-free survival time of 9. 6 months( 95% CI of 8. 5 ~ 10. 7 months) and the median survival time of 18. 8 months( 95% CI of 15. 7 ~ 21. 9 months). The observation group had the both longer than the control group( P < 0. 05). The observation group had significantly higher incidence rates of leukemia,gastrointestinal reaction,oralmucositis than the control group( P < 0. 05),but the patient can tolerate. Conclusion: S-1 used in the maintenance therapy after first-line treatment could effectively prolong the survival time of patients with advanced nasopharyngeal carcinoma and improve the curative effect.The adverse actions may be tolerated,and it is worthy of further study.