多西他赛联合顺铂、氟尿嘧啶方案治疗晚期鼻咽癌的临床观察

目的：探讨多西他赛（Docetaxel）联合氟尿嘧啶（5-Fu）、顺铂（DDP）方案治疗晚期鼻咽癌的疗效及不良反应。方法：晚期鼻咽癌患者28例,Docetaxel75mg.（m2）-1静脉滴注,第1天;5-Fu500mg.（m2）-1静脉滴注4h,第1～5天;DDP20mg.（m2）-1静脉滴注第1～5天;3周为1周期,治疗至少2个周期后评价治疗效果。结果：28例患者中,完全缓解3例,部分缓解19例,4例稳定,2例进展,总有效率为78.6%。中位缓解期4.4个月;中位生存期23.6个月。主要不良反应为白细胞减少症、胃肠道反应和脱发。白细胞计数下降总发生率为78.5%,10例患者（35.7%）发生了Ⅲ～Ⅳ级的白细胞减少症,其中3例合并了感染发热。无治疗相关死亡。结论：Docetaxel联合DDP、5-Fu治疗晚期鼻咽癌取得了较好的临床效果,其不良反应比较明显,但在可控制的范围内。

Docetaxel plus 5 - Fu and DDP in the Treatment of Advanced Nasoharyngeal Carcinoma

OBJECTIVE：To evaluate the efficacy and toxicity of Docetaxel plus 5-Fu and DDP in the treatment of advanced nasoharyngeal carcinoma.METHODS：A total of 28 patients with advanced nasopharyngeal carcinoma were treated with Docetaxel 75 mg·（m2）-1 ] iv gtt on day 1 plus 5-Fu 500 mg·（m2）-1 ] iv gtt for 4 h from day 1 to day 5 and DDP 20 mg·（m2）-1 ] iv gtt from day 1 to day 5.The treatment was repeated in every 3 weeks.After treatment for at least 2 cycles,the treatment efficacy was evaluated.RESULTS：Of the 28 cases,complete remission was achieved in 3 cases,partial response in 19,stable disease in 4 and progressive disease in 2,and the total effective rate reached 78.6%.The median remission time was 4.4 months and the median survival time was 23.6 months.The major toxicities presented as leucopenia,gastrointestinal reaction and alopecia.78.5% had leucopenia and 35.7%（10/28） appeared as grade Ⅲ or Ⅳ,and 3 cases developed leucopenia complicating infection and fever.No treatment-related death was noted.CONCLUSION：Docetaxel plus 5Fu and DDP achieved satisfactory clinical efficacy for nasopharyneal carcinoma.Its toxicity is obvious but could be kept under control.