紫杉醇脂质体联合三维适形同期放化疗治疗局部复发性鼻咽癌

Paclitaxel liposome in combination with concurrent chemotherapy of three-dimensional conformal radiation for local recurrent nasopharyngeal carcinoma

目的研究紫杉醇脂质体联合三维适形同期放化疗治疗局部复发性鼻咽癌的疗效。方法 67例病理确诊的鼻咽癌复发患者随机分为试验组和对照组。对照组33例,单纯放疗。试验组34例,放疗开始给予紫杉醇脂质体同期化疗,1次/周,40 mg/（m^2·次）,静脉输入,共5～6次,当天放疗前3 h注射结束。两组均采用三维适形技术,放疗剂量：60～64 GY/6.0～6.4周,两组分别观察疗效及不良反应。结果 61例均可评价。鼻咽癌复发病灶完全缓解（CR）试验组和对照组分别为82.3%（28/34）、54.5%（18/33）,差异有统计学意义（P〈0.05）;1年生存率试验组和对照组分别为82.3%（28/34）、51.5%（17/33）,差异有统计学意义（P〈0.05）;1年无瘤生存率试验组和对照组分别为79.4%（27/34）、51.5%（17/33）,差异有统计学意义（P〈0.05）;两组患者的主要不良反应为皮肤黏膜反应,但两组差异无统计学意义（P〉0.05）。结论紫杉醇脂质体同期放化疗近期疗效理想,无严重不良反应,能否提高长期生存率仍需进一步临床观察。

Objective To study the effect of paclitaxel liposome in combination with concurrent chemotherapy of three-dimensional conformal radiation for local recurrent nasopharyngeal carcinoma（NPC）. Methods Divided 67 patients with local recurrent NPC confirmed by pathology into two groups：test group（n=34） and control group（n=33）, test group was treated by radiation therapy plus paclitaxel liposome and control group was treated by radiation therapy alone. radiation therapy was given total dose of（60～64） Gy/6.0～6.4 week, paclitaxel liposome was given 40 mg/（m^2·time） for 5～6 times, until the radiation therapy was ended. Radiation therapy was started in 3 hours after the completion of infusion. The effects and toxicity were evaluated after the therapy. Results The CR rate of NPC in test group and control group were 82.3%（28/34）, 54.5 %（18/33）, P〈0.05. 1-year survival rate were 76.5%（26/34）, 51.5%（17/33）, P〈0.05. 1-year disease free survival rate were 79.4%（27/34）, 48.5%（16/33）,P〈0.05. The main toxicities were the reaction of skin and mucous membrane, but there was no statistical difference between the two groups. Conclusion Paclitaxel liposome can obviously increase the radio sensitiveness of local recurrent nasopharyngeal carcinoma cells. Combination of radiotherapy and paclitaxel liposome can improve the short-term effective rate of local recurrent nasopharyngeal with no serious toxicity, further observation is still needed.