紫杉醇加5-氟尿嘧啶持续滴注并联合力尔凡治疗晚期鼻咽癌的临床应用

目的 :观察紫杉醇、醛氢叶酸、5 -氟尿嘧啶 (5 -FU)持续滴注联合力尔凡治疗晚期鼻咽癌的疗效及不良反应。方法 :病理组织学确诊的晚期鼻咽癌 41例 ,分为治疗组 (2 1例 )和对照组 (2 0例 )。对照组采取以下方案 :紫杉醇 15 0 mg/m2 ,静脉滴注 3 h,第 1天 ;醛氢叶酸 2 0 0 mg/m2 ,静脉滴注 2 h,随后 5 -FU3 75 mg/m2静脉推注 10 min,再接 5 -FU3 .0 g/m2用输液泵连续滴注 48h。治疗组的治疗在上述方案的基础上 ,同时使用力尔凡 2 0 mg/d,静脉滴注。以上治疗每 3周重复 ,至少完成 2个疗程治疗。结果 :治疗组及对照组的有效率(CR+ PR)分别为 5 2 .3 %、45 .0 % ,中位生存期分别为 11.2个月、10 .8个月 ,1a生存率分别为 3 3 .3 % (7/2 1)、3 0 .0 % (6/2 0 ) ,3 a生存率分别为 9.5 % (2 /2 1)、10 .0 % (2 /2 0 ) ,上述两组间的各项指标差异均无显著性 (P>0 .0 5 ) ;临床受益率分别为 80 .9%、45 .0 % ,差异有显著性 (P<0 .0 5 )。两组的主要不良反应为骨髓抑制、周围神经炎、消化道反应、肌肉和关节疼痛、脱发等。治疗组发热多见 (P<0 .0 5 )。结论 :紫杉醇、醛氢叶酸、5 -氟尿嘧啶持续滴注治疗晚期鼻咽癌疗效确切 ,不良反应可以为患者所耐受 ,加用力尔凡可提高临床受益反应水平 ,可改善患者生活质量 ,值得

Mannatide plus paclitaxel, leucovorin and 5-Fluorouracil for treating advanced nasopharyngeal carcinoma

Objective: To observe the effects and side effects of mannatide (Lifein) plus paclitaxel, leucovorin and 5-Fluorouracil (5-Fu) on advanced nesopharyngeal carcinoma (NPC). Methods: Forty-one patients with advanced NPC were divided into two groups. Control group (n=20) received intravenous infusion of paclitaxel (150 mg/m2) for 3 hours and leucovorin (200 mg/m2) for 2 hours, followed by intravenous bolus of 5-Fu (375 mg/m2) for 10 minutes,and then 48 hour-infusion of 5-Fu (3.0 g/m2) with infusion pump. In addition to the same regimen, treatment group (n=21) also accepted intravenous infusion of mannatide (20 mg/d). The chemotherapy regimen was repeated every 3 weeks. All patients underwent two courses at least. Results: In treatment and control groups, the effective rates were 52.3% and 45.0%, the median survivals were 11.2 and 10.8 months, 1-year survival rates were 33.3% and 30.0%; and 3-year survival rates were 9.5% and 10.0%, respectively. There was no significant difference between two groups(P>0.05).The rate of clinical benefit response in treatment group was superior to that in control group (80.9% vs 45.0%, P<0.05). The common adverse effects were neutropenia, peripheral neuropathy, nausea, vomiting, arthralgia, myodynia and alopecia. Fever was more common in treatment group. Conclusion: Paclitaxel plus leucovorin and 5-Fu treatment is effective for advanced NPC, and the combination of mannatide can increase the clinical benefit response and improve the quality of life for the patients.