多西他赛联合奈达铂治疗PF方案耐药复发转移鼻咽癌的临床观察

Clinical observation of combination of taxotere and nedaplatin in the treatment of PF regimen resistant metastatic and recurrent nasopharyngeal carcinoma

目的:评价多西他赛联合奈达铂治疗对PF方案耐药复发、转移晚期鼻咽癌的初步疗效及其毒副反应,探讨治疗鼻咽癌的二线化疗方案。方法:诊断明确的转移、放疗后复发且对PF方案耐药的晚期鼻咽癌患者45例,奈达铂80mg/m2,静脉滴入,d1;多西他赛75mg/m2,静脉滴入,d2,每3周重复。化疗2个周期后根据WHO制定的实体瘤客观疗效评价标准和抗癌药物毒性分级(0～Ⅳ)标准评价疗效和不良反应。结果:45例患者共完成142个周期化疗,每例患者化疗周期数2～6个,中位化疗周期数为3个。完全缓解(CR)2例,部分缓解(PR)24例,稳定(SD)13例,进展(PD)6例,总有效率为57.8%(26/45)。1年生存率为66.7%(30/45)。毒副反应主要表现为脱发,粒细胞和血小板、血色素中轻度减少,其余毒副反应较少。结论:多西他赛联合奈达铂治疗对PF方案耐药的晚期鼻咽癌有效率高,不良反应可以耐受,是治疗晚期鼻咽癌较好的二线化疗方案。

OBJECTIVE：To evaluate the effectiveness and side effects of the combination of docetaxel and nedaplatin in the treatment of PF regimen resistant metastatic and recurrent nasopharyngeal carcinoma.METHODS： Forty-five patients with metastatic and recurrent nasopharyngeal carcinoma after treatment were enrolled.They were all failed to the treatment by Cisplatin and 5-fluorouracil（PF）.The treatment regimen include nedaplatin 80 mg/m2,d1,and taxotere 75 mg/m2,d2.Cycles were repeated every 3 weeks The treatment effects were evaluated by WHO criterion every 2 cycles and toxicities were evaluated by Common Toxicity Criteria（CTC） Version 3.0.RESULTS：Totally 142 cycles of chemotherapy were conducted in 45 patients.Patient received 2-4 cycles with average of 3 cycles.Complete response（CR） was observed in 2 patients,Partial response（PR） in 24 patients,Stable disease（SD） in 13 patients and Progression disease（PD） in 6 patients result in total response rate of 57.8%（26/45） and 1 year survival rate of 66.7%（30/45）.The main toxicity were mild alopecia,neutropenia,thrombocytopenia and anemia.Other tixicities were very rare.CONCLUSION： Combination of docetaxel and nedaplatin is an ffective regimen in the treatment of metastatic and recurrent nasopharyngeal carcinoma who are failed to PF regimen.It＇s an effective and tolerable second-line chemotherapy.