多西他赛联合顺铂及替吉奥在局部晚期鼻咽癌中的近期临床疗效及安全性
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摘要
目的研究多西他赛联合顺铂及替吉奥在局部晚期鼻咽癌中的近期临床疗效及安全性。方法选取2016年2月-2018年2月我院收治的94例局部晚期鼻咽癌患者为研究对象,以随机法均分成观察组与对照组。对照组诱导化疗方案为多西他赛联合顺铂及氟尿嘧啶,观察组诱导化疗方案为多西他赛联合顺铂及替吉奥。比较两组患者的近期临床疗效、治疗前后免疫功能、毒副反应发生情况。结果观察组近期总有效率显著高于对照组(P<0.05)。治疗后观察组血清IL-12、IFN-γ水平显著高于对照组,而血清MMP-2水平显著低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论多西他赛联合顺铂及替吉奥诱导化疗对局部晚期鼻咽癌患者的近期临床疗效显著,可改善免疫功能,且不增加不良反应。
Objective To investigate the short-term clinical efficacy and safety of docetaxel combined with cisplatin and S-1 for locally advanced nasopharynx cancer. Methods A total of 94 patients with locally advanced nasopharynx cancer admitted to our hospital between February 2016 and February 2018 were selected as subjects, and they were randomly divided into the observation group and control group.The control group was treated with docetaxel combined with cisplatin and fluorouracil, while the observation group was treated with docetaxel combined with cisplatin and S-1. The differences were compared between the two groups in clinical short-term efficacy, immune function before and after treatment, and toxic and side effects. Results The short-term total effective rate of the observation group was higher than that of the control group(P<0.05). After treatment, the levels of serum IL-12 and IFN-γ were higher in the observation group than in the control group, while the levels of serum MMP-2 were lower in the observation group than in the control group(all P<0.05). No significant differences were found between the observation group and the control group in the incidences of gastrointestinal response, peripheral nerve damage, liver and kidney dysfunction, bone marrow suppression and leukopenia(all P>0.05). Conclusion Docetaxel combined with cisplatin and S-1 had significant short-term clinical efficacy in the treatment of locally advanced nasopharynx cancer. It could help improve the immune function of patients without increasing the incidence of toxic side effects. So it is safe and worthy of clinical application.
Objective To investigate the short-term clinical efficacy and safety of docetaxel combined with cisplatin and S-1 for locally advanced nasopharynx cancer. Methods A total of 94 patients with locally advanced nasopharynx cancer admitted to our hospital between February 2016 and February 2018 were selected as subjects, and they were randomly divided into the observation group and control group.The control group was treated with docetaxel combined with cisplatin and fluorouracil, while the observation group was treated with docetaxel combined with cisplatin and S-1. The differences were compared between the two groups in clinical short-term efficacy, immune function before and after treatment, and toxic and side effects. Results The short-term total effective rate of the observation group was higher than that of the control group(P<0.05). After treatment, the levels of serum IL-12 and IFN-γ were higher in the observation group than in the control group, while the levels of serum MMP-2 were lower in the observation group than in the control group(all P<0.05). No significant differences were found between the observation group and the control group in the incidences of gastrointestinal response, peripheral nerve damage, liver and kidney dysfunction, bone marrow suppression and leukopenia(all P>0.05). Conclusion Docetaxel combined with cisplatin and S-1 had significant short-term clinical efficacy in the treatment of locally advanced nasopharynx cancer. It could help improve the immune function of patients without increasing the incidence of toxic side effects. So it is safe and worthy of clinical application.
引文
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[6]李媛媛,金风,吴伟莉,等.时辰诱导化疗序贯同步放化疗治疗局部晚期鼻咽癌的Ⅱ期临床研究[J].中国肿瘤临床, 2013, 40(15):914-918. doi:10.3969/j. issn.1000-8179.2013.15.009.
[7]Veyseller B, Ozucer B, Degirmenci N, et al. Olfactory bulb volume and olfactory function after radiotherapy in patients with nasopharyngeal cancer[J]. Auris Nasus Larynx, 2014,41(5):436-440. doi:10.1016/j. anl.2014.02.004.
[8]李媛媛,金风,吴伟莉,等.磁共振灌注成像在重组人血管内皮抑制素联合放化疗治疗局部晚期鼻咽癌中的临床研究[J].中华放射医学与防护杂志, 2017, 37(4):264-268. doi:10.3760/cma. j. issn.0254-5098.2017.04.005.
[9]魏佳,化怡纯,尚昆,等.诱导化疗联合同步放化疗与单纯同步放化疗分别治疗局部晚期头颈部肿瘤的系统评价[J].中国医院用药评价与分析, 2017, 17(7):872-875.doi:10.14009/j. issn.1672-2124.2017.07.003.
[10]尚艺泰,杨洁,李磊,等.重组人血管内皮抑制素联合放化疗治疗局部晚期头颈部鳞癌[J].昆明医科大学学报,2017, 38(7):80-84.
[11]杨丽,周洋媚,沈倩,等.局部晚期鼻咽癌TNX方案诱导化疗的近期疗效和安全性研究[J].肿瘤药学, 2018,8(4):574-576. doi:10.3969/j. issn.2095-1264.2018.04.19.
[12]罗秀玲,金风,毕婷,等. TPF方案诱导化疗不同给药方式联合调强放疗治疗局部晚期鼻咽癌的中期疗效及预后分析[J].中华放射医学与防护杂志, 2018, 38(8):595-601. doi:10.3760/cma. j. issn.0254-5098.2018.08.007.
[13]Liu H, Wang Y, Li G, et al. Clinical study of tegafurgimeracil-oteracil potassium capsule(s-1)and oxaliplatin combination chemotherapy in advanced colorectal cancer[J].J Cancer Res Ther, 2015, 11(2):331-335. doi:10.4103/0973-1482.157339.
[14]梁宁震,韩宏斌,晏党.顺铂联合替吉奥治疗晚期头颈部肿瘤的临床疗效观察[J].中国医药指南, 2014, 12(28):163.
[15]Hsieh CH, Hsu CL, Wang CH, et al. Cisplatin, tegafururacil and leucovorin plus mitomycin C:an acceptably effective and toxic regimen for patients with recurrent or metastatic nasopharyngeal carcinoma[J]. Biomed J,.2013,36(5):229-236. doi:10.4103/2319-4170.113375.
[2]Twu CW, Wang WY, Chen CC, et al. Metronomic adjuvant chemotherapy improves treatment outcome in nasopharyngeal carcinoma patients with postradiation persistently detectable plasma Epstein-Barr virus deoxyribonucleic acid[J]. Int J Radiat Oncol Biol Phys, 2014, 89(1):21-29. doi:10.1016/j. ijrobp.2014.01.052.
[3]邱幸生,刘宜敏,毕卓菲,等.局部晚期头颈部鳞状细胞癌术后同期放化疗的疗效分析[J].中华临床医师杂志(电子版), 2014, 8(14):2623-2626. doi:10.3877/cma. j.issn.1674-0785.2014.14.013.
[4]Lv X, Zhang L, Huang R, et al. A clinical exploration of neoadjuvant chemotherapy with tegafur, gimeracil, and oteracil potassium capsules combined with oxaliplatin for advanced gastric cancer[J]. Int J Clin Exp Med, 2015, 8(10):19030-19036.
[5]邓琳,王仁生,吴芳,等.局部晚期鼻咽癌不同化疗方案配合IMRT多中心前瞻性随机对照研究[J].中华放射肿瘤学杂志, 2015, 24(4):417-420. doi:10.3760/cma. j.issn.1004-4221.2015.04.016.
[6]李媛媛,金风,吴伟莉,等.时辰诱导化疗序贯同步放化疗治疗局部晚期鼻咽癌的Ⅱ期临床研究[J].中国肿瘤临床, 2013, 40(15):914-918. doi:10.3969/j. issn.1000-8179.2013.15.009.
[7]Veyseller B, Ozucer B, Degirmenci N, et al. Olfactory bulb volume and olfactory function after radiotherapy in patients with nasopharyngeal cancer[J]. Auris Nasus Larynx, 2014,41(5):436-440. doi:10.1016/j. anl.2014.02.004.
[8]李媛媛,金风,吴伟莉,等.磁共振灌注成像在重组人血管内皮抑制素联合放化疗治疗局部晚期鼻咽癌中的临床研究[J].中华放射医学与防护杂志, 2017, 37(4):264-268. doi:10.3760/cma. j. issn.0254-5098.2017.04.005.
[9]魏佳,化怡纯,尚昆,等.诱导化疗联合同步放化疗与单纯同步放化疗分别治疗局部晚期头颈部肿瘤的系统评价[J].中国医院用药评价与分析, 2017, 17(7):872-875.doi:10.14009/j. issn.1672-2124.2017.07.003.
[10]尚艺泰,杨洁,李磊,等.重组人血管内皮抑制素联合放化疗治疗局部晚期头颈部鳞癌[J].昆明医科大学学报,2017, 38(7):80-84.
[11]杨丽,周洋媚,沈倩,等.局部晚期鼻咽癌TNX方案诱导化疗的近期疗效和安全性研究[J].肿瘤药学, 2018,8(4):574-576. doi:10.3969/j. issn.2095-1264.2018.04.19.
[12]罗秀玲,金风,毕婷,等. TPF方案诱导化疗不同给药方式联合调强放疗治疗局部晚期鼻咽癌的中期疗效及预后分析[J].中华放射医学与防护杂志, 2018, 38(8):595-601. doi:10.3760/cma. j. issn.0254-5098.2018.08.007.
[13]Liu H, Wang Y, Li G, et al. Clinical study of tegafurgimeracil-oteracil potassium capsule(s-1)and oxaliplatin combination chemotherapy in advanced colorectal cancer[J].J Cancer Res Ther, 2015, 11(2):331-335. doi:10.4103/0973-1482.157339.
[14]梁宁震,韩宏斌,晏党.顺铂联合替吉奥治疗晚期头颈部肿瘤的临床疗效观察[J].中国医药指南, 2014, 12(28):163.
[15]Hsieh CH, Hsu CL, Wang CH, et al. Cisplatin, tegafururacil and leucovorin plus mitomycin C:an acceptably effective and toxic regimen for patients with recurrent or metastatic nasopharyngeal carcinoma[J]. Biomed J,.2013,36(5):229-236. doi:10.4103/2319-4170.113375.