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目的:评价多西他赛联合奈达铂治疗对PF方案耐药复发、转移晚期鼻咽癌的初步疗效及其毒副反应,探讨治疗鼻咽癌的二线化疗方案。方法:诊断明确的转移、放疗后复发且对PF方案耐药的晚期鼻咽癌患者45例,奈达铂80mg/m2,静脉滴入,d1;多西他赛75mg/m2,静脉滴入,d2,每3周重复。化疗2个周期后根据WHO制定的实体瘤客观疗效评价标准和抗癌药物毒性分级(0～Ⅳ)标准评价疗效和不良反应。结果:45例患者共完成142个周期化疗,每例患者化疗周期数2～6个,中位化疗周期数为3个。完全缓解(CR)2例,部分缓解(PR)24例,稳定(SD)13例,进展(PD)6例,总有效率为57.8%(26/45)。1年生存率为66.7%(30/45)。毒副反应主要表现为脱发,粒细胞和血小板、血色素中轻度减少,其余毒副反应较少。结论:多西他赛联合奈达铂治疗对PF方案耐药的晚期鼻咽癌有效率高,不良反应可以耐受,是治疗晚期鼻咽癌较好的二线化疗方案。
Objective: To evaluate the efficacy and toxicity of docetaxel combined with nedaplatin on PF regimen in relapse and metastasis of advanced nasopharyngeal carcinoma, and to explore the second-line chemotherapy regimen for nasopharyngeal carcinoma. Methods: 45 patients with advanced nasopharyngeal carcinoma who had definite metastasis and relapsed after radiotherapy and were resistant to PF regimen, 45 patients with nedaplatin 80 mg / m2, intravenous infusion, d1, docetaxel 75 mg / m2, d2, repeated every 3 weeks. After 2 cycles of chemotherapy, the curative effect and adverse reactions were evaluated according to the evaluation criteria of objective curative effect of solid tumors established by the WHO and the toxicity classification of anticancer drugs (0 ~ Ⅳ). Results: A total of 142 cycles of chemotherapy were completed in 45 patients. The number of chemotherapy cycles per patient was 2 to 6 and the number of cycles of median chemotherapy was 3. There were 2 cases of complete remission (CR), 24 cases of partial remission (PR), 13 cases of stable (SD) and 6 cases of progressive (PD). The total effective rate was 57.8% (26/45). The 1-year survival rate was 66.7% (30/45). Toxicity mainly manifested as alopecia, granulocytes and platelets, hemoglobin slightly reduced, the rest less toxic side effects. Conclusion: Docetaxel combined with nedaplatin is effective in advanced nasopharyngeal carcinoma (NPC) resistant to PF regimen and tolerable adverse reactions. It is a good second-line chemotherapy for advanced nasopharyngeal carcinoma.