长春瑞滨联合亚叶酸、氟尿嘧啶治疗铂类耐药的复发或转移的鼻咽癌

Venorelbine combined with fluorouracil/leucovorin in patients with nasopharyngeal carcinoma refractory to platinum based chemotherapy

目的 :研究长春瑞滨联合亚叶酸、氟尿嘧啶治疗铂类耐药的复发或转移的鼻咽癌的疗效和毒性。方法 :长春瑞滨 2 5mg/m2 ,iv,第 1天 ,第 15天 ;亚叶酸 2 0 0mg/m2 ,第 1天 ,第 15天 ,静脉输注 2小时 ;后接 5 FU 3.0g/m2 ,第 1天 ,第 15天 ,用输液泵连续静脉输注 4 8小时 ,2 8天为一疗程 ,至少完成 2周期作疗效评价。结果 :30例患者中 ,完全缓解 (CR) 1例 ,部分缓解 (PR) 15例 ,有效率为 5 3.3% ;稳定 (SD) 10例 ,临床获益率 (CBR)为 86 .7% ;疾病进展 (PD) 4例 ;中位TTP为 7.0月 (范围 2 .0～ 2 0 .0月 ) ,一年生存率为 5 1%。主要不良反应为骨髓毒性和腹泻。结论 :长春瑞滨联合亚叶酸、氟尿嘧啶治疗对铂类耐药的复发或转移的鼻咽癌 ,疗效可靠 ,毒性可耐受。

Purpose:To study the effectiveness and toxicity of venorelbine combined with fluorouracil/leucovorin in patients with nasopharyngeal carcinoma(NPC) refractory to platinum based chemotherapy.Methods:The chemotherapy regimen consisted of bimonthly intravenous infusion of venorelbine 25 mg/m 2 plus 2-hour infusion of leucovorin 200 mg/m 2 followed by 48-hour infusion of 5-FU 3.0 g/m 2 using an ambulatory pump. Results:Among 30 patients entered into the study,1 patient achieved complete response,15 patients achieved partial response with an overall response rate of 53.3% and 10 had stable disease with clinical benefit rate of 86.7% respectively. 4 patients had disease progression. Median time to progression was 7 months(range:2.0-20.0 months) and the 1-year survival rate was 51%. The main toxicities were diarrhea and myelotoxicity.Conclusions:The results indicate that venorelbine combined with fluorouracil/leucovorin in patients with nasopharyngeal carcinoma refractory to platinum based chemotherapy has moderate activity but comparatively mild toxicity.