多西紫杉醇在局部晚期鼻咽癌同期放化疗中的临床应用研究

Clinical application of docetaxel on concurrent chemo-radiotherapy in locally advanced nasopharyngeal carcinoma

目的研究1次/周多西紫杉醇单药在局部晚期鼻咽癌同期放化疗的剂量递增耐受性试验中,多西紫杉醇的剂量限制性毒性和最大耐受剂量。方法局部晚期鼻咽癌初治患者10例,常规放疗＋后程适形放疗同期使用多西紫杉醇1次/周剂量递增方案进行化疗,评价治疗相关不良反应。结果 12.5 mg/（m2.w）剂量水平3例患者中,1例出现Ⅲ级吞咽疼痛、放射皮肤炎14 d。17.5 mg/（m2.w）剂量水平5例患者中,1例患者出现Ⅱ级口干、吞咽疼痛、食欲减退、恶心、呕吐、乏力,致使放疗中断;1例出现Ⅲ级放射皮肤炎14 d。22.5 mg/（m2.w）剂量水平2例患者中,1例出现Ⅱ~Ⅲ级食欲减退、黏膜损伤、吞咽疼痛、放射皮肤炎持续18 d;1例同期放化疗3周后出现Ⅲ级黏膜损伤、吞咽疼痛,停化疗后完成放疗。结论食欲减退、黏膜损伤、吞咽疼痛、放射皮肤炎是本试验观察到的主要剂量限制性毒性。

Objective To explore the dose limit toxicity（DLT） and maximum tolerated dose of docetaxel once a week in the concurrent chemo-radiotherapy in locally advanced nasopharyngeal carcinoma.Methods Ten patients with locally advanced nasopharyngeal carcinoma received conventional radiotherapy plus conformal radiotherapy with dose escalation chemotherapy of docetaxel once a week.The adverse reactions related to treatment were evaluated.Results Among 3 patients with 12.5 mg/（m2·w）,1 patient had grade Ⅲ swallowing pain,radiation skin inflammation for 14 days.Among 5 patients with 17.5 mg/（m2·w）,1 patient had grade Ⅱ thirst,anorexia,nausea,vomiting,and weakness,which halted the treatment.One case had grade Ⅲ radiation skin inflammation for two weeks.Among 2 patients with 22.5 mg/（m2·w）,1 patient had gradeⅡ to grade Ⅲ anorexia,mucosa injury,swallowing pain and radiation skin inflammation for 18 days.One patient had grade Ⅲ mucosa injury,swallowing pain after 3-week chemotherapy,and the radiotherapy was completed after chemotherapy stopped.Conclusion The main DLT of this research includes anorexia,mucosa injury,swallowing pain and radiation skin inflammation.