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目的观察奈达铂(NDP)和5-氟尿嘧啶(5-FU)/醛氢叶酸(LV)双周疗法治疗头颈部癌的疗效和不良反应。方法28例晚期头颈部癌患者用奈达铂100 mg/m2,静脉输注,第1天;LV 200 mg/m2,静脉滴注2小时,5-FU 500 mg静脉推注,然后5-FU 2.8 g/m2持续48小时静脉滴注,第1、15天;每4周重复1次。所有病例至少接受两个疗程治疗。结果完全缓解2例(7.14%),部分缓解13例(46.43%),总有效率为53.57%。对于既往使用过顺铂(DDP)的病例中,有效率为40.0%。不良反应主要为骨髓抑制、黏膜炎和腹泻,无治疗相关死亡。结论奈达铂联合大剂量醛氢叶酸+5-氟尿嘧啶持续滴注48小时这一方案治疗晚期头颈部癌疗效可靠,对于DDP耐药的病人仍有一定的有效率,不良反应可以耐受。
Objective To observe the curative effect and adverse reactions of headache and neck cancer treated with NDP and 5-fluorouracil / aldehyde-folate (LV) bi-weekly therapy. Methods Twenty-eight patients with advanced head and neck cancer were treated with intravenous nedaplatin 100 mg / m2 on day 1; LV 200 mg / m2, intravenous drip for 2 hours, and 5-FU 500 mg intravenously. Then 5- FU 2.8 g / m2 for 48 hours intravenously, on day 1 and day 15; repeat every 4 weeks. All cases received at least two courses of treatment. Results Complete remission in 2 cases (7.14%), partial remission in 13 cases (46.43%), the total effective rate was 53.57%. In the past cases of cisplatin (DDP) cases, the effective rate was 40.0%. Adverse reactions were mainly myelosuppression, mucositis and diarrhea, with no treatment-related deaths. Conclusion Nedaplatin combined with high-dose oxyfonic acid and 5-fluorouracil sustained infusion for 48 hours is a reliable and effective method for the treatment of advanced head and neck cancer. It is still effective for DDP-resistant patients and the adverse reactions are tolerable.