卡培他滨联合重组人血管内皮抑制素治疗复发和转移鼻咽癌临床观察  

Combined therapy of capecitabine with endostatin for the treatment of recurrent and metastatic nasopharyngeal carcinoma

作　　者：廖加群[1] 薛英波[1] 吴坤励 雷竹[1] 曹雪[1] 杨洁[1] 李杭[1] 黄立敏[1] LIAO Jia-qun;XUE Ying-bo;WU Kun-li;LEI Zhu;CAO Xue;YANG Jie;LI Hang;HUANG Li-min(Department of Oncology,Guizhou Provincial People's Hospital,Guiyang 550002,P.R.China)

机构地区：[1]贵州省人民医院肿瘤科

出　　处：《中华肿瘤防治杂志》2019年第16期1192-1195,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：贵州省科技厅项目[黔科合J字2015(2088)号];贵阳市科技局项目([20141001]62号

摘　　要：目的标准放化疗后出现复发和(或)远处转移的部分鼻咽癌患者不适合再程放疗、手术及联合方案化疗.本研究旨在探讨卡培他滨联合重组人血管内皮抑制素治疗这类患者的近期疗效及不良反应.方法选取贵州省人民医院2013-01-03-2015-12-26收治的25例复发/转移鼻咽癌患者,既往完成根治性放疗及铂类联合紫杉类方案化疗,不合适再程放疗,对再联合化疗耐受性差,采用单药卡培他滨化疗(1250mg/m^2口服,2次/d,d1~d14)联合重组人血管内皮抑制素(7.5mg/m^2,静脉滴入,d1~d14)靶向治疗,21d为1个周期.观察近期疗效如疾病缓解率、有效率、疾病控制率、生活质量及不良反应,如消化道反应、骨髓抑制等,采用SPSS19.0进行统计分析.结果25例患者完全缓解率为0,95%CI:0~13.3%;部分缓解率为64.0%(16/25),95%CI:44.5%~79.7%;稳定率为20.0%(5/25),95%CI:7.5%~39.7%;进展率为16.0%(4/25),95%CI:6.4%~34.6%;有效率为64.0%(16/25),95%CI:44.5%~79.7%;疾病控制率为84.0%(21/25),95%CI:65.4%~93.6%.不良反应均为Ⅰ~Ⅱ度可耐受,无重度不良反应发生.结论通过小样本观察,对于无法进行再程放疗、联合化疗的复发/转移性鼻咽癌,采用卡培他滨联合重组人血管内皮抑制素进行维持治疗,近期疗效佳,不良反应可耐受,值得临床进一步研究.OBJECTIVE The aim of this study was to explore the recent therapeutic efficacy and toxicity of capecitabine combined with endostatin in the treatment of the patients with recurrent and/or metastatic nasopharyngeal carcinoma(NPC) who were not suitable for combined chemotherapy, surgery and radiotherapy. METHODS This study recruited 25 NPC patients with recurrent and metastasis after earlier treatment (radiotherapy plus chemotherapy) Guizhou Provincial People's Hospital. The patients underwent radical radiotherapy and chemotherahpy with platinum and taxcil. Since they were not suitable for further heavy combined chemotherapy,they received orally capecitabine at a dose of 1 250 mg/m^2 , twice a day, combined with daily intravenous infusion of 7. 5 mg/m^2 Endostar for 2 weeks. Each treatment cycle lasts 21 days. The recent therapeutic outcomes,i. e. tumor remission rate,tumor progression rate,qualities of life, toxicities and side effects were evaluated. RESULTS The recent remission rate was 0 (95%CI:0-13. 3%),partial remmison rate was 64. 0%(95%CI:44. 5%- 79. 7%),stabilization rate was 20. 0%(95%CI:7. 5%-39. 7%), progression rate was 16. 0%(95%CI:6. 4%- 34. 6%), response rate was 64. 0%(95% CI: 44. 5%- 79. 7%), disease contral rate was 84. 0%(95%CI:65. 4%-93. 6%). The side effects were well tolerated and reversible (grade Ⅰ-Ⅱ). CONCLUSION The therapeutic modality of capecitabine combined with endostatin is safe and effective in the treatment in recurrent and metastatic NPC patients with good recent therapeutic efficacy and well-tolerable side effects.

关 键 词：鼻咽癌 复发转移 卡培他滨 重组人血管内皮抑制素 

分 类 号：R739.6[医药卫生—肿瘤]