多西他赛联合顺铂治疗原发灶不明转移癌临床观察

Clinical observation of docetaxel/cisplatin combination in patients with cancer of unknown primary site

目的评价多西他赛联合顺铂治疗原发灶不明转移癌的疗效及毒副反应。方法回顾性分析2006年1月~2011年1月间我院化疗科收治的45例原发灶不明转移癌患者的临床资料。17例采用多西他赛联合顺铂方案：多西他赛60mg/m2,d1;顺铂25mg/m2,d1-3。每3周为1周期。治疗至疾病进展或出现不能耐受的毒性反应时停止。依据RECIST标准评价疗效,依据NCI CTC标准评价毒性,随访5年。其余28例采用其他方法治疗。比较两组在有效率、临床获益率和平均存活时间的差异。结果多西他赛/顺铂组17例共完成75个疗程化疗,平均每例患者完成4.41个疗程,CR 1例,PR 5例,SD 4例,有效率35.3%（95%CI 12.6%-58%）,临床获益率58.8%（95%CI 35.5%-82.1%）,平均无疾病生存期为9个月,平均存活时间为21.5个月。对照组28例,采用其他疗法,CR 1例,PR 4例,SD 5例,有效率17.9%（95%CI 3.7%-32.1%）,临床获益率35.7%（95%CI 17.9%-52.8%）,平均疾病进展期为5个月,平均存活时间为8.7个月。但两组有效率和临床获益率差异均无统计学意义（P〉0.05）。17例患者均可评价毒性,毒副反应主要为骨髓抑制、外周神经毒性和低钠血症。结论多西他赛/顺铂组治疗原发灶不明转移癌疗效较好,毒副反应可以耐受。

To evaluate the efficacy and toxicity of docetaxel/cisplatin combination chemotherapy in patients with cancer of unknown primary site（CUP）. Methods Data of 45 cases with CUP were retrospectively analyzed. 17 patients were treated with docetaxel/cisplatin combination： docetaxel 60mg/m2,d1, followed by cisplatin 25mg/m2in d1 -3 via intravenous infusion. Chemotherapy cycles were repeated every 3 weeks. The efficacy was evaluated according to RECIST criteria, and toxi- city according to American National Cancer Institute common toxicity criteria（NCI CTC）. Patients were followed up 5 years. The other 28 cases in control group were treated with other methods, including chemotherapy with or without concurrent radiotherapy for symptom control. Results 17 patients accomplished 75 courses chemotherapy in total, with average 4.41 courses per pa- tient. 1 patient obtained complete response（CR）,5 patients partial response（PR）,4 patients stable disease（SD）. As to control group, 1 patient obtained complete response（CR）,4 patients partial response（PR）,5 patients stable disease（SD）. The effective rate were 35.3%（95% CI 12.6%-58%）and 17.9%（95% CI 3.7%-32.1%）,the clinical benefit response rate were 58.8%（95%CI 35.5%-82.1%）and 35.7%（95%CI 17.9%-52.8%）, the median progression-free interval were 9 months and 5 months, the me- dian survival time were 21.5 months and 8.7 months in docetaxel/cisplatin and control group respectively. The toxicity in doc- etaxel/cisplatin group were mainly myelosuppression, hyponatremia and mild neurotoxicity. Conclusion Docetaxel/cisplatin combination is effective and safe for patients with cancer of unknown primary site. It can relieve the symptoms and improve the quality of life of the patients with CUP.