CAJ | 학술논문

目的评价多西紫杉醇(docetaxel)在晚期复发鼻咽癌(NPC)综合治疗中的作用.方法 56例初治转移性或放化疗后复发或转移的鼻咽癌患者,接受docetaxel+顺铂(DDP)+氟尿嘧啶(5-Fu)化疗,其中docetaxel 70 ms/m2静滴,6 h,第1天;DDP 70 ms/m2静滴,第1天,或总量分2～3 d给予;5-Fu 400～500 ms/m2静滴,6 h,第1～5天;每3～4周重复.化疗有效者至少4～6个疗程或一直治疗至疾病进展(PD)为止.结果本组有51例(91.1%)患者可以评价客观疗效,其中完全缓解(CR)5例,部分缓解(PR)32例,稳定(sD)9例,进展(PD)5例,总缓解(CR+PR)率为72.5%(37/51),CR率为9.8%(5/51),sD率为17.6%(9/51).在初治的17例患者中,CR 5例,PR 9例,SD 3例,无PD患者,治疗后有效率为82.4%,CR率为29.4%;在复治的34例患者中,PR 22例,SD5例,PD 7例,治疗后有效率为64.7%,无CR患者.经随访,有12例患者进展,其中5例死亡.全组56例患者共接受196个疗程化疗,主要不良反应为骨髓抑制及恶心呕吐,其次为脱发、乏力、口腔黏膜炎和腹泻.骨髓抑制主要表现为白细胞下降,发生率为48.0%,其中Ⅲ～Ⅳ度者占21.6%.有2例发生发热性粒细胞减少,经积极处理好转,未出现严重的全身感染和与治疗相关死亡.结论 docetaxel联合5-Fu、DDP方案是治疗晚期复发鼻咽癌的有效方案,临床使用安全,值得进一步的临床研究.
목적 평개다서자삼순(docetaxel)재만기복발비인암(NPC)종합치료중적작용.방법 56례초치전이성혹방화료후복발혹전이적비인암환자,접수docetaxel+순박(DDP)+불뇨밀정(5-Fu)화료,기중docetaxel 70 ms/m2정적,6 h,제1천;DDP 70 ms/m2정적,제1천,혹총량분2～3 d급여;5-Fu 400～500 ms/m2정적,6 h,제1～5천;매3～4주중복.화료유효자지소4～6개료정혹일직치료지질병진전(PD)위지.결과본조유51례(91.1%)환자가이평개객관료효,기중완전완해(CR)5례,부분완해(PR)32례,은정(sD)9례,진전(PD)5례,총완해(CR+PR)솔위72.5%(37/51),CR솔위9.8%(5/51),sD솔위17.6%(9/51).재초치적17례환자중,CR 5례,PR 9례,SD 3례,무PD환자,치료후유효솔위82.4%,CR솔위29.4%;재복치적34례환자중,PR 22례,SD5례,PD 7례,치료후유효솔위64.7%,무CR환자.경수방,유12례환자진전,기중5례사망.전조56례환자공접수196개료정화료,주요불량반응위골수억제급악심구토,기차위탈발、핍력、구강점막염화복사.골수억제주요표현위백세포하강,발생솔위48.0%,기중Ⅲ～Ⅳ도자점21.6%.유2례발생발열성립세포감소,경적겁처리호전,미출현엄중적전신감염화여치료상관사망.결론 docetaxel연합5-Fu、DDP방안시치료만기복발비인암적유효방안,림상사용안전,치득진일보적림상연구.
Objective This clinical study was designed to evaluate the efficacy and toxicity of the combined regimen of docetaxel,5-Fu and DDP(TPF)in the treatment of advanced or relapsed nasopharyngeal carcinoma(NPC).Methods Fifty-six patients with newly diagnosed or recurrent/metastatic NPC following chemotherapy or radiotherapy were enrolled.Both docetaxel and DDP were administered intravenously for 6 hours at the dose of 70 ms/m2on D1.5-Fu was given at a dose of 400～500ms/m2for 6 hours from D1 to D5.Dexamethasone was routinely administered before injection of docetaxel.This combination was repeated every 3 to 4 weeks.and continued for 4～6 cycles or until PD for the responders.Results Fifty-one(91.1%)patients were evaluable for response assessment.The response rate for whole group was 72.5%(37/51)with a CR rate of 9.8%(5/51).The stable disease accounted for 17.6%(9/5 1).There were 17(30.4%)chemotherapy.naive patients.The overall response rate in those was 82.4%with a CR rate of 29.4%.However.the response rate for previously treated patients was 64.7%without CR.Twelve patients had progressed disease.including 5(8.9%)died of disease progression with a median follow-up of 11 month(ranged from 1 to 19 months).Totally,196 courses of chemotherapy were administered.The major toxicity was myelosupression.nausea/vomiting.The incidence of leucopenia was 48%with 22.2%of these in NCI grade Ⅲ or Ⅳ.But only 2 patients(3.6%)experienced leucopenia with a fever.Other mild toxicities including alopecia,asthenia,mucositis and diarrhea were also observed.Conclusion Our preliminary outcome shows docetaxel.5-Fu and DDP combination is effective and safe for the patients with advanced or relapsed nasopharyngeal carcinoma.But futher clinical study is warrantds.