含奈达铂方案治疗恶性肿瘤的回顾性分析

Retrospective Analyses of Nedaplatin-Contained Therapy for Carcinoma

目的:分析含奈达铂方案治疗鼻咽癌、食管癌、肺癌、宫颈癌的临床应用情况,评价其近期疗效及毒副反应。方法:68例患者,按治疗方案分3组:奈达铂单药同步放疗(A组)34例;奈达铂联合多西他赛化疗(B组)20例;联合化疗同步放疗(C组)14例。结果:68例患者中,52例可评价疗效,14例为宫颈癌术后,1例因过敏停药,1例死亡。鼻咽癌、食管癌、肺癌的近期疗效分别为90.00%,76.92%,31.58%。67例可评价毒副反应,其中骨髓抑制52例(77.61%),Ⅲ+Ⅳ度白细胞减少14例(20.90%),Ⅲ+Ⅳ度血小板减少13例(19.40%);消化道反应14例(20.90%);尿素氮增高1例。结论:奈达铂对放疗有增效作用;其骨髓抑制发生率较高;奈达铂可导致过敏性休克,临床上应重视。

Objective： To evaluate the therapeutic and toxic effect of nedaplatin-contained therapy in the treatment of carcinomas.Methods： A total of 68 cases who had confirmed diagnosis with nasopharyngeal,lung,cervical,or esophageal carcinomas,respectively,by pathology.All cases were divided into three groups as： Group A,34 cases of nasopharyngeal carcinoma or esophageal carcinoma received radiotherapy and chemotherapy（nedaplatin）;Group B,20 cases of lung cancer received chemotherapy（nedaplatin and docetaxel）;and Group C,14 cases of cervical carcinoma treated with radiotherapy and chemotherapy（nedaplatin and docetaxel）.Results： Therapeutic results could be evaluated in 52 cases of A and B groups,one case discontinued therapy for allergic reaction,and one case died.The response rate（RR） of nedaplatin-contained therapy for nasopharyngeal carcinoma,esophageal carcinoma and lung cancer was 90.00%,76.92%,and 31.58%,respectively.The major toxic effect is bone marrow suppression observed in 52 cases（77.61%）,of which grade Ⅲ＋Ⅳ aleukocytosis was observed in 14 cases（20.90%）,and grade Ⅲ＋Ⅳ thrombocytopenia in 13 cases（19.40%）.Fourteen cases（20.90%） showed gastrointestinal reaction.One case had increased urea nitrogen（grade Ⅰ）.None of them had peripheral nerve or heart toxicity.Conclusion： Nedaplatin can increase the therapeutic effect of radiation.Its incidence rate of bone marrow suppression is high,but the gastrointestinal reaction and renal toxicity is low and mild,respectively.Nedaplatin would cause anaphylactic shock,which should be paid attention to in the clinical application.