摘要
目的评价重组人血管内皮抑制素联合标准放化疗治疗局部区域晚期鼻咽癌的安全性及近期疗效。方法选择我院收治的13例局部区域晚期鼻咽癌患者,治疗方案采用3周期TP方案(紫杉醇脂质体135~175 mg·m^(-2)或多西他赛75mg·m^(-2)联合顺铂75 mg·m^(-2),21 d为1周期)新辅助化疗+顺铂(100 mg·m^(-2),21 d为1周期,共2周期)同时期放化疗,患者放疗开始后第8~21 d给予重组人血管内皮抑制素(7.5 mg·m^(-2))靶向治疗。放化疗结束后12周,根据RECIST 1.1版评价近期疗效,按照NCICTC 3.0版标准评价急性毒性反应的发生情况。结果联合治疗方案耐受性好,3例患者出现放疗暂停,但均按计划完成放疗;所有患者均按计划完成重组人血管内皮抑制素靶向治疗;76.9%的患者按计划完成2周期顺铂同时期化疗。重组人血管内皮抑制素联合同时期放化疗期间最常见的Ⅲ~Ⅳ度毒性反应分别为粘膜炎、中性粒细胞减少、白细胞减少、血小板减少、皮肤反应和呕吐,3例患者出现Ⅳ度急性毒性,未发生毒性相关的死亡。12例患者治疗后12周肿瘤完全缓解,1例部分缓解,客观有效率100%。结论重组人血管内皮抑制素联合标准放化疗方案治疗局部晚期鼻咽癌具有较好的安全性。
Objective To explore the safely and tumor response for patients with locally advanced nasopharyngeal carcinoma （LANPC） treated with ehemoradiotherapy and rh-endostatin. Methods Thirteen LANPC patients were prospectively recruited. All patients were treated by TP regimen （paelitaxel liposome 135-175 mg.m-2 or doeetaxe175 mg.m-2combined with eisplatin 75 mg.m-2, every 3 weeks, for 3 eyeles） neoadjuvant ehemotherapy and followed by eoneun＇ent ehemoradiotherapy using eisplatin （100 mg.m-2 every 3 weeks, for 2 eyeles）. Rh-endostalin （7.5 mg.m2） was given belween day 8 and day 21 after initiation of radiotherapy. At twelve weeks after ehemoradiotherapy, their acute toxicity was evaluated according to the NCI CTC version 3.0 and tumor response rate was evaluated by RECIST version 1.1. Results The combined treatment was well tolerated. Three （23.1%） patients had radiotherapy suspension, but all of them completed radio- therapy eventually. All patients received full cycle of rh-endostatin and 76.9% patients completed two cycles of eisplatin concurrent chemo- therapy. The most common grade Ⅲ-IV acute toxic reactions were mueositis, neutropenia, leueopenia, thromboeytopenia, dermatitis and vomiting. Three patients developed grade IV toxieity and no grade V toxieity was observed. Twelve patients developed complete response and only one patient developed partial response. The objective response rate was 100%. Conclusion The addition of rh-endostatin to stand- ard ehemoradiotherapy for patients with LANPC is feasible and safe. It may improve treatment outeome.
作者
李宇
李燕娴
王茗
刘怀
李煜
郭戈杨
王勇
胡英
罗英
Li Yu;Li Yanxian;WANG Ming;LiU Huai(Hunan Cancer Hospital /The Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha,Hunan,410013,China)
出处
《肿瘤药学》
CAS
2018年第4期560-565,共6页
Anti-Tumor Pharmacy
基金
国家自然科学基金(81502658)
湖南省自然科学基金(2016JJ6092)
湖南省卫生计生委基金(B2016053)
作者简介
李宇，男，住院医师，研究方向：恶性肿瘤放射治疗的临床及转化研究，E-mail：myly8000@sina．com。;通讯作者：罗英，女，主任医师，研究方向：恶性肿瘤放射治疗的临床研究，E—majl：luoying@hnszlyy．com
