转移性鼻咽癌的系统性治疗  

Systemic treatment in metastatic nasopharyngeal carcinoma

作　　者：郭晔[1] 

机构地区：[1]复旦大学附属肿瘤医院肿瘤内科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2011年第12期927-931,共5页China Oncology

摘　　要：随着同期放化疗和调强放疗在鼻咽癌治疗中的广泛应用,远处转移已经成为鼻咽癌治疗失败的主要原因,特别是对于局晚Ⅳ期的患者。虽然转移性鼻咽癌是不可治愈性疾病,但不排除某些不含高危因素的患者有可能长期生存。目前,转移性鼻咽癌的一线标准化疗方案尚未确定,常用组合包括铂类分别联合氟脲嘧啶、紫杉类或吉西他滨,其肿瘤缓解率通常超过50%,中位生存期为12～18个月。近年来的研究显示,卡培他滨和奥沙利铂加入一线化疗方案获得了良好的效果和治疗耐受性。在一线含铂类方案失败以后,选择抗代谢类药物卡培他滨和吉西他滨治疗,大约超过1/3的患者可以获得肿瘤缓解,中位生存期可以超过1年。靶向药物中,西妥昔单抗已被证明有解救治疗的作用,其在一线治疗领域的作用仍有待研究。With the broad administration of concurrent chemoradiation and intensity-modulated radiation therapy（IMRT）,distant metastasis becomes the major reason of treatment failure in nasopharyngeal carcinoma,especially for patients with locally advanced stage IV disease.Although metastatic nasopharyngeal carcinoma is incurable,some patients without high risk could achieve a long-tem survival.At present,the standard first-line chemotherapy remains uncertain and common options include platinum plus fluoropyrimidine,taxane or gemcitabine.The overall response rate of such combination chemotherapy could exceed 50% and median overall survival is about 12-18 months.Recently,the integration of capecitabine or oxaliplatin in first-line treatment has been proved good efficacy and treatment compliance.In patients with platinum-resistant disease,capecitabine or gemcitabine,which is an antimetabolite has been commonly used.More than one thirds of patients could respond to either of agents with a median survival of more than one year.Among targeted agents,cetuximab has shown efficacy in salvage setting and its role in first-line setting warrants investigation.

关 键 词：转移性鼻咽癌 化疗 靶向治疗 

分 类 号：R739.63[医药卫生—肿瘤]