一线化疗临床获益后替吉奥维持治疗在转移性鼻咽癌患者中的应用效果  

Application effect of S-1 as maintenance therapy on patients with metastatic nasopharyngeal carcinoma achieving clinical benefits after first-line chemotherapy

作　　者：韦柳君 陆颖[1] 黄海欣[1] 杨慧[1] 胡晓桦[2] 黄昌杰[3] 刘美莲[4] 冯献斌 WEI Liu-jun;LU Ying;HUANG Hai-xin;YANG Hui;HU Xiao-hua;HUANG Chang-jie;LIU Mei-lian;FENG Xian-bin(Department of Oncology,the Forth Affiliated Hospital of Guangxi Medical University,Liuzhou 545000,China;Department of Oncology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Oncology,the Second Nanning People′s Hospital,Nanning 530031,China;Department of Radiotherapy,Affiliated Hospital of Guilin Medical University,Guilin 541001,China;Department of Oncology,Liuzhou Traditional Chinese Medical Hospital,Liuzhou 545001,China)

机构地区：[1]广西医科大学第四附属医院肿瘤科,柳州市545000 [2]广西医科大学第一附属医院肿瘤科,南宁市530021 [3]广西南宁市第二人民医院肿瘤科,南宁市530031 [4]桂林医学院附属医院放疗科,广西桂林市541001 [5]广西柳州市中医医院肿瘤科,柳州市545001

出　　处：《广西医学》2021年第15期1789-1791,1800,共4页Guangxi Medical Journal

基　　金：广西自然科学基金(2017GXNSFBA198005);广西医药卫生科研课题(Z2016167);广西柳州市科技计划(2016G020203);广西柳州市科技计划项目重大专项(2019AF10601)。

摘　　要：目的探讨一线化疗临床获益后替吉奥维持治疗在转移性鼻咽癌患者中应用的有效性及安全性。方法95例经综合治疗后临床诊断为进展转移的鼻咽癌(病理诊断为鳞状细胞癌)患者,一线化疗后(经影像学评价为临床获益)3周内,接受替吉奥维持化疗(体表面积<1.5 m^(2)者,口服50 mg/次,体表面积≥1.5 m^(2)者,口服60 mg/次,2次/d,治疗2周,休息1周,3周为1周期,至疾病进展或不能耐受),最终纳入可评价病例88例。以开始维持治疗为观察起点,随访8.0~51.3个月,计算患者的无进展生存期(PFS)、总体无进展生存率、总生存期(OS)、总体生存率,记录维持化疗期间的不良反应。结果患者的总体无进展生存率为78.2%,总体生存率为44.3%,中位PFS为16.2个月,中位OS为32.1个月。替吉奥维持治疗时间为4~58个周期,中位时间为14个周期,主要不良反应括皮肤色素沉着、口腔黏膜炎、手足综合征及贫血等,经治疗方案调整或短期治疗延迟患者均可耐受,且未出现4级毒性反应。结论对于已接受一定周期一线化疗并达到临床获益的转移性鼻咽癌患者,替吉奥维持治疗有较好的临床疗效,不良反应可耐受。Objective To investigate the efficacy and safety of maintenance therapy with S-1 applied to patients with metastatic nasopharyngeal carcinoma achieving clinical benefits after first-line chemotherapy.Methods Ninety-five nasopharyngeal carcinoma patients clinically diagnosed as progression and metastasis after comprehensive treatment(pathologically diagnosed as squamous cell carcinoma)received S-1 maintenance chemotherapy within three weeks after achieving clinical benefits from first-line chemotherapy identified by imaging assessment.In the maintenance chemotherapy,patients with body surface area<1.5 m^(2)were given oral administration of S-1 at a dose of 50 mg twice daily,those with body surface area≥1.5 m^(2)were given oral administration of S-1 at a dose of 60 mg twice daily.Three weeks represented one treatment cycle,S-1 chemotherapy was performed in the first two weeks and not in the third week.All patients received maintenance therapy with S-1 until disease progression or intolerance.Ultimately,88 cases eligible for assessment were enrolled.The beginning of maintenance therapy was defined as starting point for observation,the follow-up lasted for 8.0 to 51.3 months,and the progression-free survival(PFS),overall progression-free survival rate,overall survival(OS)and overall survival rate were calculated,and the adverse reactions during maintenance chemotherapy were recorded.Results The patients obtained an overall progression-free rate of 78.2%and an overall survival rate of 44.3%,as well as a median PFS of 16.2 months and a median OS of 32.1 months.The duration of maintenance therapy with S-1 ranged from 4 to 58 cycles,with a median of 14 cycles.The common adverse reactions included skin pigmentation,oral mucositis,hand-foot syndrome and anemia,which were tolerated by patients after treatment regimen adjustment or short-term delayed treatment;no grade 4 toxic response occurred.Conclusion For metastatic nasopharyngeal carcinoma patients achieving disease benefits after first-line chemotherapy of certain cy

关 键 词：转移性鼻咽癌 进展转移 替吉奥 维持治疗 一线化疗后 

分 类 号：R739.6[医药卫生—肿瘤]