THP-ADM联合VDS治疗铂类耐药晚期鼻咽癌的临床观察  

Clinical Study of Advanced Nasopharyngeal Carcinoma Being Resistant to Cisplatin or Carboplatin Treated with Pirarubicin and Vindesine

作　　者：徐瑞华[1] 姜文奇[1] 邹青峰[1] 何友兼[1] 管忠震[1] 

机构地区：[1]中山医科大学肿瘤医院内科,广州市510060

出　　处：《中国肿瘤临床》2000年第3期201-203,共3页Chinese Journal of Clinical Oncology

摘　　要：目的 :探讨铂类治疗耐药的晚期、复发的鼻咽癌 ,应用吡喃阿霉素 (THP- ADM)、长春酰胺 (VDS)联合化疗方案进行治疗的疗效。方法 :共入选 35例铂类治疗耐药的晚期、复发的鼻咽癌患者 ,应用 THP- ADM及 VDS联合化疗方案进行治疗。具体用药为 THP- ADM5 0 mg/ m2 ,iv,dl;VDS3mg/ m2 ,iv,dl～ 5 ,每 3周重复疗程 ,每例至少化疗 2疗程。按 WHO标准评价疗效及毒性。结果 :32例可评价客观疗效病例中 ,9例获得 PR(2 8.1% ) ,其中 7例PR者为 DDP或卡铂继发耐药的病例 (有效率 35 .0 % ,7/ 2 0 ) ,另外 2例为对 DDP或卡铂原发耐药的患者 (16 .7% ,2 / 2 1) ,铂类继发耐药的病例似乎较原发耐药的患者有效率高 ,但无统计学差异 (P=0 .477)。有效病例的中位缓解期为 4.3个月 (范围 2～ 10 .6个月 )。主要不良反应是 、 级的骨髓抑制以及恶心、呕吐。结论 :该方案对铂类治疗耐药的晚期、复发的鼻咽癌患者有一定的治疗价值 ,且毒性较低 ,患者易耐受 ,值得进一步研究。Objective:To evaluate the effects of combination regimen of Pirarubicin (THP-ADM) and Vindesine (VDS) in treating advanced or relapsed nasopharyngeal carcinoma (NPC) being resistant to cisplatin or carboplatin.Methods:A total of 35 cases of advanced NPC being resistant to cisplatin or carboplatin were studied.All patients were treated with THP-ADM (50mg/m 2 on d1) and VDS (3mg/m 2 on d1 and d5) combination regimen. The courses were repeated every 3 weeks for at least 2 cycles.The response and toxicity were assessed according to the partial remission.The overall response rate was 28.1%.The patients being secondarily resistant to cisplatin or carboplatin seemed to have a higher effectiveness than that of the primary resistance,but no statistical difference was found.The response duration was 4.3 months (ranged 2 to 10.6 months).The major side effects were grade Ⅰ and Ⅱ myelosuppression,nausea and vomiting.Conclusion: This regimen is effective in the treatment of NPC resistant to cisplatin or carboplatin and toxicity of this regimen is mild and tolerable.

关 键 词：吡喃阿霉素 长春酰胺 药物疗法 鼻咽肿瘤 

分 类 号：R739.63[医药卫生—肿瘤]