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目的探讨低剂量氟尿嘧啶(5-Fu)、顺铂(DDP)联合多烯紫杉醇(docetaxel)治疗晚期头颈部肿瘤的临床疗效、生存期和耐受性。方法32例晚期头颈部肿瘤患者,接受小剂量5-Fu、DDP联合多烯紫杉醇方案化疗。5-Fu 300 mg/d,持续静脉泵入,第1~14天给药;DDP 5~10 mg/d,静滴,第1~5、8~12天给药;多烯紫杉醇35 mg/m2,静滴,第1、8天给药,21 d为1周期。化疗2周期以上,以后按WHO标准评价疗效和耐受性。全组患者均进行生存期随访。结果32例患者均可评价疗效,获得完全缓解(CR)2例,部分缓解(PR)12例,稳定(SD)10例,进展(PD)8例,有效率43.8%(14/32)。全组患者均进行随访,随访4~22个月,中位生存期13个月,中位肿瘤进展时间(TTP)6.5个月。临床受益改善率59.4%(19/32)。主要不良反应为骨髓抑制,Ⅲ~Ⅳ度白细胞减少的发生率15.6%(5/32),其余不良反应如恶心呕吐、黏膜炎和脱发等均较轻微。结论低剂量氟尿嘧啶、顺铂联合多烯紫杉醇治疗晚期头颈部肿瘤的疗效较好,并能改善患者的生活质量,主要不良反应为骨髓抑制,有待于进一步临床应用。
Objective To investigate the clinical efficacy, survival and tolerability of low-dose 5-fluorouracil and cisplatin (DDP) combined with docetaxel in the treatment of advanced head and neck cancer. Methods Thirty-two patients with advanced head and neck cancer underwent chemotherapy with low-dose 5-Fu and DDP combined with docetaxel. 5-Fu 300 mg / d, continuous intravenous infusion, the first to 14 days of administration; DDP 5 ~ 10 mg / d, intravenous drip on days 1-5,8 to 12 days; docetaxel 35 mg / m2, intravenous infusion, the first 1,8 days of administration, 21 d for a cycle. Chemotherapy more than two cycles later by the WHO evaluation of efficacy and tolerability. All patients were followed up for survival. Results All 32 patients were evaluated with complete remission (CR) in 2 cases, partial remission (PR) in 12 cases, stable (SD) in 10 cases and progression (PD) in 8 cases. The effective rate was 43.8% (14/32). All patients were followed up for 4 to 22 months with a median survival of 13 months and a median time to tumor progression (TTP) of 6.5 months. Clinical benefit improvement rate of 59.4% (19/32). The main adverse reaction was myelosuppression. The incidence of grade Ⅲ ~ Ⅳ leukopenia was 15.6% (5/32). Other adverse reactions such as nausea and vomiting, mucositis and alopecia were mild. Conclusion Low-dose fluorouracil and cisplatin combined with docetaxel in the treatment of advanced head and neck cancer have better curative effect, and can improve the quality of life of patients. The main adverse reaction is myelosuppression, which needs further clinical application.