Zhou Juan, Zhang Wei-min, Chen Hai, Xie Bo, Zheng Ji-hua, Xu Zhi-yong, Lin Jin-rong
Department of Medical Oncology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China.
Zhonghua Zhong Liu Za Zhi. 2009 Nov;31(11):867-72.
The aim of this study was to compare the results of different combined chemotherapy regimens and to find the best regimen for metastatic nasopharyngeal carcinoma (NPC), and determine its prognostic factors.
The clinical data of 171 patients with pathologically proven metastatic NPC were retrospectively analyzed. Of them, 26 were treated with best support care (BSC group), 92 with platinum-based regimen of two drugs (FP group: 5-Fu and cisplatin; TP group: paclitaxel and cisplatin; DP group: docetaxel and cisplatin), and 53 with platinum-based regimen of three-drugs (TFP group: FP plus paclitaxel, DFP group: FP plus doxtale).
The response rate (RR) in the three-drug regimens was significantly higher than that in the two-drug regimen (84.9% vs. 52.2%, P = 0.000), however, grade III approximately IV myelosuppression in the three-drug regimen group was also significantly higher than that in the two-drug regimen (58.5% vs. 27.2%, P = 0.000). Among the groups treated with platinum-based combination regimens of either two drugs or three drugs, no significant differences were observed in RR (P = 0.967, P = 0.400) or median survival time (MST) (P = 0.278, P = 0.413). The MST and one-year survival rate were 4.0 months, 13.2 months and 15.0 months, 24.0%, 64.1% and 70.3% in the BSC group, two-drug group and three-drug group, respectively. The MST in the chemotherapy group was significantly longer than that in BSC group (P = 0.000). Cox multivariate regression analysis showed that Karnovsky performance scores, time to progression or chemotherapy cycles were independent prognostic factors (P < 0.05).
Chemotherapy can improve the survival of metastatic NPC. Platinum-based combination regimen with two drugs is still the standard treatment. The combination regimens with three drugs can increase the RR, but no survival benefit can be achieved for its high toxicity.
本研究旨在比较不同联合化疗方案的结果，寻找转移性鼻咽癌（NPC）的最佳方案，并确定其预后因素。
回顾性分析171例经病理证实的转移性NPC患者的临床资料。其中，26例接受最佳支持治疗（BSC组），92例接受两药铂类方案（FP组：5-氟尿嘧啶和顺铂；TP组：紫杉醇和顺铂；DP组：多西他赛和顺铂），53例接受三药铂类方案（TFP组：FP加紫杉醇，DFP组：FP加多西他赛）。
三药方案的缓解率（RR）显著高于两药方案（84.9%对52.2%，P = 0.000），然而，三药方案组的III～IV级骨髓抑制也显著高于两药方案（58.5%对27.2%，P = 0.000）。在接受两药或三药铂类联合方案治疗的组中，RR（P = 0.967，P = 0.400）或中位生存时间（MST）（P = 0.278，P = 0.413）无显著差异。BSC组、两药组和三药组的MST和1年生存率分别为4.0个月、13.2个月和15.0个月，24.0%、64.1%和70.3%。化疗组的MST显著长于BSC组（P = 0.000）。Cox多因素回归分析显示，卡氏功能状态评分、疾病进展时间或化疗周期是独立的预后因素（P < 0.05）。
化疗可提高转移性NPC的生存率。两药铂类联合方案仍是标准治疗。三药联合方案可提高RR，但因其高毒性不能带来生存获益。
Zotero 插件