多西他赛联合奥沙利铂对局部晚期鼻咽癌诱导化疗的安全性及近期疗效  

Safety and Efficacy of Induction Chemotherapy with Docetaxel Combined Oxaliplatin in Locally Advanced Nasopharyngeal Carcinoma

作　　者：邹岚[1] 蒋金妍[1] 张晓丽[1] 庞学利[1] 边志衡[1] 梁后杰[1] 

机构地区：[1]第三军医大学附属西南医院肿瘤科,重庆400038

出　　处：《肿瘤防治研究》2010年第7期834-837,共4页Cancer Research on Prevention and Treatment

摘　　要：目的研究多西他赛联合奥沙利铂方案对局部晚期鼻咽癌诱导化疗的安全性及近期疗效。方法 35例初治的局部晚期鼻咽癌患者接受多西他赛(75mg/m2)联合奥沙利铂(135mg/m2)的3周方案诱导化疗两个疗程,评价不良反应与近期疗效。结果 35例患者共完成66周期诱导化疗,主要不良反应为:6.06%(4/66)发生3级以上白细胞减少,62.12%有(40/66)轻度疲乏,1.5%(1/66)有3度疲乏;40.9%(27/66)有1～2级恶心呕吐,12.12%(8/66)有1～2级腹泻,无3级以上胃肠道反应发生,13.63%(9/66)发生肌肉痛和关节痛,全部患者均有不同程度的脱发。35例中,诱导化疗对鼻咽部原发灶客观有效率为20.0%(7/35);其中29例颈部淋巴结阳性患者中,颈部淋巴结转移灶CR、PR分别为13.79%(4/29)、65.51%(19/29),客观有效率为79.31%(23/29,95%CI65%～94%)。全部患者鼻咽部原发灶及颈部淋巴结均未进展。结论多西他赛+奥沙利铂方案用于局部晚期鼻咽癌治疗,近期疗效确切,不良反应可以耐受。其远期疗效有待于进一步证实。Objective To evaluate the safety and efficacy of docetaxel and oxaliplatin induction chemotherapy in patients with locally advanced nasopharyngeal carcinoma （LANPC）.Methods From May 2007 to June 2008,35 previously untreated LANPC patients received induction chemotherapy with docetaxel,75 mg/m^2,day 1 and oxaliplatin,135 mg/m^2,day 1,every 3 weeks.Nineteen patients were in Stage Ⅲ and 16 in Stage ⅣA.All patients but four received 2 cycles of induction chemotherapy.Total cycles were 66.All patients were evaluated for toxicity and responses.Results Toxicities from induction chemotherapy were：6.06% （4/66） grade 3 or 4 haematological toxicity of neutropenia,62.12%（40/66）grade 1 or 2 and 1.5%（1/66）grade 3 fatigue,40.9%（27/66）grade 1 or 2 nausea/vomiting,12.12%（8/66）grade 1 or 2 diarrhea,none had grade 3 or 4 gastrointestinal toxicity,13.63% （9/66）grade 1 or 2 arthralgia and myalgia,all patients had hair loss.In the end of induction phase,overall response rate（ORR） of nasopharyngeal primary lesion was 20.0%（7/35）,ORR of metastatic lymph nodes was 79.31%（23/29,95% CI 65%~94%）,with 13.79%（4/29） CR and 65.51%（19/29）PR respectively.No patient had PD in both nasopharyngeal primary lesion and metastatic lymph nodes.Conclusion In LANPC induction chemotherapy with docetaxol plus oxaliplatin was well tolerated.High rate of response to induction therapy as well as to completed treatment was achieved.Long-term Therapeutic Effects of this sequence of treatment need further exploration.

关 键 词：鼻咽癌 诱导化疗 多西他赛 奥沙利铂 

分 类 号：R739.63[医药卫生—肿瘤]