5-FU经颞浅动脉120小时持续灌注治疗高T分期鼻咽癌的I期临床试验  

Phase I clinical trial of nasopharyngeal carcinoma at high T stage treated with 5-FU continued infusion for 120 hours through superficial temporal artery

作　　者：任培蓉[1] 吴敬波[1] 何丽佳[1] 吴天革[1] 张建文[1] 尚昌玲[1] 

机构地区：[1]泸州医学院附属医院肿瘤科,四川泸州646000

出　　处：《中国癌症防治杂志》2009年第2期142-144,147,共4页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

摘　　要：目的研究5-FU经颞浅动脉120h持续化疗高T分期鼻咽癌的最大耐受剂量(MTD)。方法对29例病理确诊为鼻咽癌的初治高T分期(T_3或T_4)患者采用颞浅动脉插管化疗。化疗方案:5-FU+顺铂,观察5-FU持续120h动脉灌注化疗的不良反应以及最大的耐受剂量。5-FU的剂量分别为200、300、350、400、450、500mg/m^2,120h持续动脉滴注;顺铂20mg,第1～5天动脉快速滴注;21d为1疗程,共2个疗程。结果不良反应:29例病人均出现口腔黏膜反应,其中Ⅰ度1例为200mg/m^2组;Ⅱ度12例200mg/m^2组中5例,300mg/m^2岔组5例,350mg/m^2组2例;Ⅲ度11例300mg/m^2组中1例,350mg/m^2组3例,400mg/m^2组5例,450mg/m^2组2例;Ⅳ度5例450mg/m^2组中3例,500mg/m^2组2例;5例出现局部疼痛,对症治疗后好转。29例病人出现的骨髓抑制、消化道反应以及肝肾功能损害均在Ⅰ度和Ⅱ度。疗后原发灶CR 2例,PR 25例,SD 2例;有效率(CR+PR)为93%。颈部淋巴结CR 1例,PR 16例,SD 0例,余12例患者颈淋巴结为阴性,有效率(CR+PR)为100%。结论5-FU经颞浅动脉持续化疗高T分期鼻咽癌,患者耐受尚可,最大耐受剂量为350mg/m^2。Objective To determine the maximum tolerated dose of 5-Flouruorail （5-FU） via superficial temporal arterial infusion for the patients with T3/T4 nasopharyngeal carcinoma. Methods A total of 29 patients were enrolled in this study. They were treated with 5-FU plus Cisplatin. A chemotherapy cycle was designed as 21 days and all patients were treated for 2 cycles. 5-FU was administrated by pump infusion for continuous 120-hour via superficial temporal arterial. The maximum tolerated dose of 5-FU was determined by testing increasing doses on different groups of patient until the highest dose with acceptable side effects was found. Cisplatin was infused via superficial temporal artery （20mg/m^2/d, d1-5 ） for all the patients. Results 5-FU induced oral mucositis in all patients. Of the 29 patients, 1 patient experienced grade Ⅰ mucositls in group 200mg/m^2 ; 12 patients experienced grade Ⅱ mucositis which included 5 in group 200mg/m^2 ,5 in group 300mg/m^2 and 2 in group 350rag/m^2 ; 11 patients experienced grade Ⅲ mucositis which included 1 in group 300mg/m^2 ,3 in group 350mg/m^2 ,5 in group 400mg/m^2 and 2 in group 450mg/m^2 ; 5 patients experienced grade Ⅳ mucositis which included 3 in group 450mg/m^2 and 2 in group 500mg/m^2. Five patients experienced oral mucosal pain. For the primary tumor,2 cases achieved complete remission （CR） ,25 achieved partial remission （PR） and 2 presented stable disease （SD） ,in which the overall response rate （ CR ＋ PR） was 93%. For the neck lymph nodes, the cases of CR, PR and SD were 1,16 and 0 respectively,the rest 12 were neck-node-negative,in which the CR ＋ PR was 100%. Conclusions Superficial temporal arterial infusion with 5-FU for T3/T4 nasopharyngeal carcinoma is well tolerated. The maximum tolerated dose of 5-FU is 350mg/m^2.

关 键 词：鼻咽癌 5-FU 动脉化疗 最大耐受剂量 

分 类 号：R739.63[医药卫生—肿瘤]