PENTOCLO方案治疗中晚期放射性鼻咽颅底骨坏死的疗效及安全性  

Curative efficacy and safety of PENTOCLO regimen for osteoradionecrosis of nasopharynx and skull base

作　　者：汤轶强[1] 敖帆[1] 黄敏[1] 谢建国[1] 陈淑兰 廖瑜露[1] 陈媛媛[2] 肖芸[1] 龚晓昌[1] 李金高[1] TANG Yiqiang;AO Fan;HUANG Min;XIE Jianguo;CHEN Shulan;LIAO Yulu;CHEN Yuanyuan;XIAO Yun;GONG Xiaochang;LI Jingao(Department of Radiation Oncology,Jiangxi Cancer Hospital,Jiangxi Nanchang 330029,China;Department of Radiotherapy,Zhejiang Cancer Hospital,Zhejiang Hangzhou 310022,China)

机构地区：[1]江西省肿瘤医院放疗科,江西南昌330029 [2]浙江省肿瘤医院放疗科,浙江杭州310022

出　　处：《现代肿瘤医学》2021年第11期1867-1870,共4页Journal of Modern Oncology

基　　金：国家癌症中心攀登基金(编号:NCC20184B039);江西省卫健委科研课题(编号:20161107)。

摘　　要：目的:根据PENTOCLO方案(己酮可可碱、维生素E、双膦酸盐)治疗中晚期放射性鼻咽颅底骨坏死的近期疗效和不良反应,探讨抗纤维化药物治疗的可行性。方法:选取2019年01月至2019年10月间江西省肿瘤医院收治的12例中晚期放射性鼻咽颅底骨坏死患者。患者均为Ⅱ期和Ⅲ期放射性鼻咽颅底骨坏死患者。患者均采用PENTOCLO方案进行药物治疗及加强鼻咽冲洗保守治疗,并纳入治疗组。选取2019年01月前采用加强鼻咽冲洗为基础保守治疗的35例患者纳入历史对照组。比较两组患者的客观疗效及药物不良反应。结果:治疗组中位用药时间6个月,治疗有效率为83.3%(10/12)。治疗组中位用药时间和有效率优于历史对照组的2年和40.0%(14/35),差异均有统计学意义(P<0.05);治疗组病死率为0(0/12),低于对照组的25.7%(9/35),差异有统计学意义(P<0.05)。治疗组中3例服药后出现轻微不良反应,无患者因药物不良反应停药。结论:PENTOCLO方案配合加强鼻咽冲洗治疗中晚期放射性鼻咽颅底骨坏死的近期疗效显著,不良反应轻微,患者依从性良好。Objective:To explore the feasibility of anti-fibrotic medicines in the treatment of osteoradionecrosis of nasopharynx and skull base,based on the short-term curative efficacy and adverse events of the combination of pentoxifylline,vitamin E and a bisphosphonate(PENTOCLO regimen).Methods:A total of 12 patients with advanced osteoradionecrosis of nasopharynx and skull base who were admitted to Jiangxi Cancer Hospital from January 2019 to October 2019 were selected.The patients were patients with stageⅡand stageⅢosteoradionecrosis of nasopharynx and skull base.The patients were treated with PENTOCLO regimen and conservative treatment based on enhanced nasopharyngeal irrigation,and were included in the treatment group.Thirty-five patients who received conservative treatment based on enhanced nasopharyngeal irrigation before January 2019 were enrolled into the historical control group.The objective curative effect and adverse events of the two groups of patients were compared.Results:There was a significantly shortened median treatment duration(6 months vs 2 years),a significantly greater effective rate[83.3%(10/12)vs 40.0%(14/35)]and a significantly lower mortality rate[0(0/12)vs 25.7%(9/35)]in the treatment group than in the historical control group(P<0.05).There were mild adverse events in 3 patients and no discontinuation due to adverse events in the treatment group.Conclusion:Concomitant use of PENTOCLO regimen and enhanced nasopharyngeal irrigation has a significant short-term curative efficacy,a low incidence of adverse events and good patient compliance in the treatment of osteoradionecrosis of nasopharynx and skull base.

关 键 词：PENTOCLO方案 放射性鼻咽颅底骨坏死 疗效 加强鼻咽冲洗 

分 类 号：R739.6[医药卫生—肿瘤]