TPS1新辅助化疗对局部晚期鼻咽癌的疗效观察  

Clinical Observation of TPS1 Neoadjuvant Chemotherapy for Patients with Locally Advanced Nasopharyngeal Carcinoma

作　　者：韩亚骞[1] 何倩[1] 刘林[1] 刘峰[1] 张琳[1] 罗乐[1] 马宏志[1] 李云[1] 席许平[1] 肖锋[1] 吴湘玮[1] 王晖[1] 

机构地区：[1]湖南省肿瘤医院,410013

出　　处：《实用癌症杂志》2017年第11期1791-1793,1800,共4页The Practical Journal of Cancer

基　　金：湖南省自然科学基金项目(编号:2016JJ4059);肿瘤放射治疗转化医学湖南省重点实验室项目(编号:2015TP1009)

摘　　要：目的研究局部晚期鼻咽癌使用TPS1新辅助化疗的ORR及不良反应,探讨TPS1替代TPF新辅助化疗的可能性。方法对29例局部晚期鼻咽癌,使用TPS1新辅助化疗2个周期后行同步放化疗。结果 TPS1新辅助化疗后BMI(体重指数)变化中位数0.34(0~1.1),总体放化疗后BMI(体重指数)变化中位数1.1(0.73~2.11)。新辅助化疗后鼻咽部即时疗效评价:CR 4例(13.8%),PR 24例(82.8%),SD 1例(3.4%),ORR 96.6%。总体放化疗后鼻咽部即时疗效评价:CR 22例(75.9%),PR 7例(24.1%),ORR 100.0%。TPS1新辅助化疗后全组无4级不良反应,罕见3级不良反应,大多为0~1级不良反应,2级反应主要为恶心(48.0%),呕吐(21.0%),白细胞减少(24.0%)和中性粒细胞减少(14.0%)。整体放化疗结束后全组无4级不良反应,少见3级不良反应(口腔黏膜炎除外)。主要急性毒副作用表现为血液毒性,放射性皮炎,口腔黏膜炎,口干,脱发和呕吐。结论对局部晚期鼻咽癌使用TPS1新辅助化疗有很好的近期疗效及较低的毒副反应,TPS1有替代TPF方案的可能。Objective To investigate the ORR and toxicity of TPS1 neoadjuvant chemotherapy for locally advanced naso- pharyngeal carcinoma, and to explore the possibility of replacing TPF with TPS1. Methods 29 patients with locally advanced na- sopharyngeal carcinoma were treated with TPS1 neoadjuvant chemotherapy for 2 cycles followed by concurrent chemoradiotherapy. Results The median change of BMI （ body mass index） after neoadjuvant chemotherapy with TPSI was 0.34 （0 - 1.1 ）, the median change of BMI was 1.1 （0.73 - 2.11 ） after overall treatment. Immediate effect of nasopharyngeal region after TPS1 neo- adjuvant chemotherapy, the CR, PR, SD and ORR were 13.8 %, 82.8 %, 3.4% and 96.6%, respectively. Immediate effect of na- sopharyngeal region after overall treatment, the CR, PR and ORR were 75.9%, 24.1% and 100.0%, respectively. After TPS1 neoadjuvant chemotherapy,the maximum toxxicity were no grade 4 toxicities, grade 3 rarely, mostly concentrated in grade 0 ~ 1,2 grade mainly concentrated in nausea （48.0%） and vomiting （21.0%） ,leukopenia （24.0%） and neutropenia （ 14.0% ）. After Overall treatment, the maximum toxicity were no grade 4 toxicities, rare grade 3 （except for oral mucosal inflammation）. The main acute toxicity was mainly hematological toxicity, radiation dermatitis, oral mucositis, dry mouth, vomiting and hair loss. Conclusion TPS1 neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma achieved good treatment response with low toxicity, and the TPS1 has the potential to replace the TPF regimen.

关 键 词：TPS1 新辅助化疗 局部晚期 鼻咽癌 疗效 

分 类 号：R739.63[医药卫生—肿瘤]