转移性鼻咽癌化疗方案的临床研究

发布时间：2019-06-29 22:26

【摘要】：目的分析根治性放疗后发生远处转移鼻咽癌患者化疗和疗效的临床资料，为临床选择和实施适当的挽救性化疗提供依据。 方法回顾性分析根治性放疗后发生远处转移鼻咽癌化疗患者临床资料，Kaplan-Meier法计算生存率，χ2检验比较顺铂为基础的双药联合化疗方案与奥沙利铂为基础的双药联合化疗方案、紫杉类+铂类与吉西他滨+铂类的有效率（RR）差别，Log-rank test比较治疗到进展的时间（TTP）差别。 结果全组114例患者，10例失访，随访率91.2%。全组中位随访时间20个月（3～83个月），90例死亡，24例存活患者中位随访53.5个月（10～83个月）。全组中位生存时间20个月，1、2、3年生存率分别为66.5%、41.2%、27.2%。114例患者共化疗511周期，顺铂为基础的双药联合化疗方案RR为73.4%，奥沙利铂为基础的双药联合化疗方案RR为84.0%，两者RR差别无统计学意义（P=0.136）,两者中位TTP均为8个月；紫杉类+铂类与吉西他滨+铂类的RR分别为87.1%、86.0%，差别无统计学意义（P=0.865）,两者中位TTP分别为7个月、12个月，差别无统计学意义（P=0.497）。 结论：对于根治性放疗后局部和区域控制良好的远处转移鼻咽癌患者，，顺铂为基础的双药联合化疗方案与奥沙利铂为基础的双药联合化疗方案比较、紫杉类+铂类与吉西他滨+铂类比较，不管是有效率还是治疗到进展的时间，均无明显差别。
[Abstract]:Objective to analyze the clinical data of chemotherapy and curative effect in patients with distant metastasis of nasopharyngeal carcinoma (NPC) after radical radiotherapy, and to provide evidence for clinical selection and implementation of appropriate rescue chemotherapy. Methods the clinical data of patients with distant metastasis of nasopharyngeal carcinoma (NPC) after radical radiotherapy were analyzed retrospectively. the survival rate was calculated by Kaplan-Meier method. The difference of the effective rate between taxoid platinum and gemcitabine platinum was compared between the combination chemotherapy regimen based on platinum and oxaliplatin, and the difference in the time (TTP) between the treatment and the progress of treatment by Log-rank test. Results of the 114 patients, 10 were lost, the follow-up rate was 91.2%. The median follow-up time was 20 months (3 鈮

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