CAJ | 학술논문

目的：探讨希罗达在晚期鼻咽癌患者一线治疗后的维持治疗中的疗效。方法选取2003年1月至2008年12月我院收治的65例晚期鼻咽癌患者，以上患者均已进行4~6周期的一线治疗，采用随机数字表法将其分为观察组（45例）和对照组（20例）。观察组患者给予希罗达800~1000 mg·m-2治疗，2次/d，持续给药；对照组患者不采用希罗达治疗，观察和比较两组患者的总生存率(OS)、无进展生存率、总有效率与不良反应的发生情况。结果对照组无疾病进展生存期为7个月（95％置信区间为5.6~9.8个月），中位生存期为15.7个月（95％置信区间为13.2~18.4个月）；观察组无疾病进展生存期为12.5个月（95％置信区间为8.4~17.6个月），中位生存期为34.3个月（95％置信区间为25.6~43.4个月），均显著长于对照组（P<0.05）。两组患者的OS均随治疗时间的延长而下降，观察组患者6~12个月、12~18个月的OS均显著高于对照组，差异均有统计学意义（P<0.05）。观察组的总有效率为75.6％，显著高于对照组（50.0％），差异具有统计学意义（P<0.05）。观察组患者手足综合征、胃肠道反应、肝肾功能异常的发生率均显著高于对照组，差异有统计学意义（P<0.05）。结论晚期鼻咽癌患者在一线治疗结束后给予希罗达维持治疗，能够有效地延长患者的生存时间，提高疗效，但不良反应的发生率也升高，临床上应当酌情应用。
목적：탐토희라체재만기비인암환자일선치료후적유지치료중적료효。방법선취2003년1월지2008년12월아원수치적65례만기비인암환자，이상환자균이진행4~6주기적일선치료，채용수궤수자표법장기분위관찰조（45례）화대조조（20례）。관찰조환자급여희라체800~1000 mg·m-2치료，2차/d，지속급약；대조조환자불채용희라체치료，관찰화비교량조환자적총생존솔(OS)、무진전생존솔、총유효솔여불량반응적발생정황。결과대조조무질병진전생존기위7개월（95％치신구간위5.6~9.8개월），중위생존기위15.7개월（95％치신구간위13.2~18.4개월）；관찰조무질병진전생존기위12.5개월（95％치신구간위8.4~17.6개월），중위생존기위34.3개월（95％치신구간위25.6~43.4개월），균현저장우대조조（P<0.05）。량조환자적OS균수치료시간적연장이하강，관찰조환자6~12개월、12~18개월적OS균현저고우대조조，차이균유통계학의의（P<0.05）。관찰조적총유효솔위75.6％，현저고우대조조（50.0％），차이구유통계학의의（P<0.05）。관찰조환자수족종합정、위장도반응、간신공능이상적발생솔균현저고우대조조，차이유통계학의의（P<0.05）。결론만기비인암환자재일선치료결속후급여희라체유지치료，능구유효지연장환자적생존시간，제고료효，단불량반응적발생솔야승고，림상상응당작정응용。
Objective To investigate the curative effects of Xeloda on the maintenance therapy after first line treatment of patients with advanced nasopharyngeal carcinoma. Methods We selected 65 cases of patients with advanced nasopha-ryngeal carcinoma admitted in our hospital between January 2003 and December 2008. All the patients had first line treat-ment for 4~6 cycles. Then they were randomly divided into the observation group (45 cases) and control group (20 cases). Patients in observation group were treated with 800~1000 mg·m-2 of Xeloda, 2 times/d, with sustained drug delivery;and those in control group did not have Xeloda treatment. The overall survival rate (OS), progression free survival rate, total ef-ficacy as well as incidence of adverse reactions were observed and compared between the two groups. Results The control group had the progression-free survival time of 7.0 months (95%confidence interval (CI) of 5.6~9.8 months) and the median survival time of 15.7 months (95%CI of 13.2~18.4 months). The observation group had the progression-free survival time of 12.5 months (95%CI of 8.4~17.6 months) and the median survival time of 34.3 months (95%CI of 25.6~43.4 months). The observation group had the both longer than the control group (P<0.05). The OS of both groups were decreased with the extension of treatment time, but the 6~12 months' and 12~18 months' OS of observation group were significantly higher than those of the control group (P<0.05). The total effective rate of observation group was 75.6%, significantly higher than that of the control group (50.0%) (P<0.05). However, the observation group had significantly higher incidence rates of hand foot syndrome, gastrointestinal reaction, liver and kidney dysfunction than the control group (P<0.05). Conclusion Xeloda used in the maintenance therapy after first line treatment could effectively prolong the survival time of patients with advanced nasopharyngeal carcinoma and improve the curative effect, but the incidence rates of adverse reactions were also increased. Therefore, it should be appropriately considered in clinical application.