多西紫杉醇联合顺铂治疗原发灶不明癌的疗效观察

Therapeutic effect of combination of docetaxel and cisplatin in patients with unknown primary cancer

目的:分析多西紫杉醇联合顺铂治疗原发灶不明癌的疗效。方法:回顾性分析了2004年1月至2008年2月期间收治的15例原发灶不明癌患者,均未经过化疗,PS评分0-2,有可测量病灶,无器官功能障碍。方案:多西紫杉醇60mg/m2,d1;顺铂80mg/m2,d2,静脉化疗,每21天为一个周期,每2个周期后评价疗效。病情未出现进展者共完成4-6个周期。结果:15例患者中有1例因经济原因仅化疗1个周期,其余14例患者总有效率为50%,95%可信区间23%-77%,疾病控制率为78.6%,95%可信区间49%-98%;中位进展时间为5.5个月,中位生存时间为11.6个月;无化疗相关性死亡,常见的不良反应为白细胞减少(1-3级13人),恶心呕吐(1-2级11人),肾毒性(1-2级3人),外周神经毒性(1级3人),肝脏毒性(1-2级,3人),心脏毒性(1级1人)。结论:多西紫杉醇联合顺铂治疗原发灶不明转移癌安全有效,不良反应可以耐受。

Objective：To evaluate the therapeutic effect of docetaxel and cisplatin in the treatment of unknown primary cancer.Methods：To retrospectively analysise 15 with patients carcinoma in an unknown primary organ,no prior chemotherapy.Docetaxel（60 mg/m2） followed by cisplatin（80 mg/m2） was administered intravenously every 21 days.Patients were assessed for tumor response after 2 cycles of chemotherapy,and 4-6 cycles were administered unless disease progression was demonstrated.Results：Among 15 patients enrolled,1 patient abandoned treatment after 1 cycle of chemotherapy,overall response rate was 50%,95% confidence interval： 23%-77%,clinical disease control rate was 78.6%,95% confidence interval： 49%-98%;The median time to progression was 5.5 months.The median survival time was 11.6 months.No treatment-related deaths were observed.Commonly observed side effects included neutropenia（grade 1-3,13 patients）,nausea and vomitting（grade 1-2,11 patients）,nephrotoxicity（grade1-2,3 patients）,neurovirulence（grade 1,3 patients）,hepatotoxicity（grade1-2,3 patients）,and cardiotoxicity（grade1,1 patients）.Conclusion：These results indicate that the combination of docetaxel and cisplatin is a safe and effective regimen for patients with unknown primary cancer,and the toxicity can be tolerated.