摘要
背景和目的:对于放疗后复发、远处转移的鼻咽癌,标准的化疗方案为DDP+5-FU或DDP+5-FU/CF,但有效率特别是完全缓解率较低,即使有效的患者,缓解时间亦不够长,因此,临床上仍需寻找新的更有效的化疗方案。本临床研究的目的是评价异环磷酰胺(ifosfamide,IFO)和阿霉素(doxorubicine,ADM)联合(ID)方案治疗常规放化疗后复发转移鼻咽癌(NPC)的疗效和不良反应。方法:IFO1200mg/m2ivd第1-5天,美斯纳400mg于IFO后0、3、6h静脉推注,ADM50mg/m2(或表阿霉素,Epirubicine60mg/m2)iv第1天,每3-4周重复。结果:36例放化疗后局部复发和远处转移鼻咽癌患者接受ID方案化疗,34例可评价疗效,16例患者曾用全身化疗。ID方案化疗后总有效率67.6%,CR率14.7%,中位缓解时间6个月。曾用化疗16例患者中,总有效率50%,1例CR,中位缓解时间5个月;未化疗患者18例,总有效率83.3%,CR率22.2%,中位缓解时间8个月。本组36例患者共接受109疗程化疗,不良反应主要为骨髓抑制,WBC下降发生率达94.8%,其中WHOIII+IV度占33.1%,24.8%疗程需用G-CSF支持,发热性中性粒细胞减少占14.6%,无严重全身感染。血小板下降发生率8.4%,贫血11.5%;其它不良反应有食欲下降,恶心呕吐,口腔炎,脱发。结论:ID方案是治疗复发NPC的有效方案,可考虑作为DDP+5-FU治疗失败后的挽救?
Background and Objective:DDP+5 Fu and DDP+5 FU/CF is the standard regimen for the treatment of the patients with recurrent and metastatic nasopharyngeal carcinoma at the present time. The response rate and complete response(CR) rate are still low with short duration of response.More effective regimen was needed. This clinical trial was designed to evaluate the efficacy and toxicity of ifosfamide(IFO) and doxorubicin(ADM)regimen for treatment of the patients with recurrent and metastatic nasopharyngeal carcinoma (NPC) after radiotherapy. Method: Ifosfamide was administered intravenously at the dose of 1 200 mg/m2 from day 1 to day 5 with uroprotection of Mesna in fusion at 0,3,and 6 hours following initiation of IFO.Doxorubicin was given at the dose of 50mg/m2 intravenously(or Epirubicin 60 mg/m2) at day 1.This combination was repeated every 3 to 4 weeks. Results:Thirty six patients with recurrent and metastatic NPC following radiotherapy were enrolled,in which 16 patients previously treated by systemic chemotherapy. Thirty four patients were evaluable for response. The response rate for whole group was 67.6%with CR rate of 14.7%. Median duration of response was 6 months.The response rate of previously patients treated with and without chemotherapy were 50.0%and 83.3%,respectively,and the median duration of response were 5 months and 8 months,respectively.A total of 109 courses of chemotherapy were administered for 34 patients.The major toxicity was myelosupression.The incidence of leucopenia was 94.8%with 33.1%of grade 3/4. Febrile leucopenia account for 14.6%and G CSF was necessary in 24.8%cycles without severe systemic infection and thromocytopenia 8.4%,anemia 11.5%. Meanwhile,other toxicities included loss of appetite,nausea/vomiting, stomatitis, and alopecia were observed. Conclusions:Ifosfomide and Doxorubicine is an effective regimen for the patients with recurrent and metastatic nasopharyngeal carcinoma. This combination may be considered as salvage therapy for NPC patients who fail to DDP 5 Fu treatment and warranted further clinical study.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2002年第4期409-411,共3页
Chinese Journal of Cancer
