紫杉醇加顺铂联合化疗治疗晚期鼻咽癌的临床研究

Clinical research on the combination of paclitaxel and cisplatin in the treatment of advanced nasopharyngeal carcinoma

目的 观察紫杉醇加顺铂联合化疗对晚期鼻咽癌的客观疗效及毒副作用。方法 采用紫杉醇175 mg/m /d1+顺铂30 mg/d1~5化疗,每3周重复,连续2 个周期诱导化疗晚期(Ⅲ、Ⅳ期)鼻咽癌患者42例。结果 鼻咽病灶无CR病例,PR 33例(78.57%),颈转移淋巴结CR 2 例(4.6%),PR 36 例(85.71%)。Ⅲ、Ⅳ期有效率分别为87 50%(21/24)和88 88%(16/18),总有效率(CR+PR)88 09%(37/42),较紫杉醇单药或同类研究高,毒副作用仍以白细胞下降(88. 07%)及恶心呕吐(95.23%)明显,但多为Ⅰ~Ⅱ度反应。结论 紫杉醇加顺铂联合化疗治疗晚期鼻咽癌近期疗效明显,能迅速减轻局部肿瘤负荷,是晚期鼻咽癌诱导化疗较理想的方案。

Objective To evaluate the efficacy and toxicity of combination of paclitaxel and cisplatin in the treatment of advanced nasopharyngeal carcinoma.Methods 42 cases of patients with advanced nasopharyngeal carcinoma were treated with paclitaxel 175mg/m^2/d1 and cisplatin 30mg/d1～d5,which was repeated every three weeks and continued for two courses.Results In nasopharyngeal lesions,no case obtained complete response(CR),the partial response(PR) obtained in 33 cases(78.57%);then in cervical lymph nodes,CR obtained in 2 cases(4.76%) and PR in 36 cases(85.71%).The effective rate was 87.50%(21/24) and 88.88%(16/18) in stage Ⅲ and Ⅳ,the total effective rate(CR+PR) was 88.09%(37 cases).The major toxic effects were leukopenia(88.07%) and nausea(95.32%);but most was Ⅰ～Ⅱ degree reaction.Conclusion The efficacy of combination of paclitaxel and cisplatin is obvious,and it is a perfect regimen in the treatment of advanced nasopharyngeal carcinoma.