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PGC方案诱导化疗后同步放化疗治疗Ⅲ~ⅣA期鼻咽癌的Ⅱ期单中心前瞻性临床研究[J]. 肿瘤防治研究, 2014, 41(09): 998-1001. DOI: 10.3971/j.issn.1000-8578.2014.09.010
引用本文: PGC方案诱导化疗后同步放化疗治疗Ⅲ~ⅣA期鼻咽癌的Ⅱ期单中心前瞻性临床研究[J]. 肿瘤防治研究, 2014, 41(09): 998-1001. DOI: 10.3971/j.issn.1000-8578.2014.09.010
A Prospectively Monocentric Phase Ⅱ Clinical Analysis on PGC Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Stage Ⅲ-ⅣA Nasopharyngeal Carcinoma Patients[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 998-1001. DOI: 10.3971/j.issn.1000-8578.2014.09.010
Citation: A Prospectively Monocentric Phase Ⅱ Clinical Analysis on PGC Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Stage Ⅲ-ⅣA Nasopharyngeal Carcinoma Patients[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 998-1001. DOI: 10.3971/j.issn.1000-8578.2014.09.010

PGC方案诱导化疗后同步放化疗治疗Ⅲ~ⅣA期鼻咽癌的Ⅱ期单中心前瞻性临床研究

A Prospectively Monocentric Phase Ⅱ Clinical Analysis on PGC Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Stage Ⅲ-ⅣA Nasopharyngeal Carcinoma Patients

  • 摘要: 目的 评价脂质体紫杉醇、吉西他滨、卡铂三药联合的诱导化疗(PGC方案)序贯同步放化疗治疗中晚期鼻咽癌患者的疗效及不良反应。方法 对初治Ⅲ~ⅣA期33例鼻咽癌患者, 给予2周期PGC方案新辅助化疗,序贯同步放化疗。诱导化疗方案:脂质体紫杉醇135 mg/m2+吉西他滨1 000 mg/m2+卡铂,血药浓度-时间曲线下面积(area under the curve,AUC)取5,第一天给药,每三周一次。第7周开始调强放射治疗同步化疗,卡铂AUC=5, 每三周一次。结果 在PGC诱导化疗两周期后评价:7例(21%)完全缓解(CR),21例(64%)部分缓解(PR),4例(12%)稳定(SD),1例(3%)进展(多发性肺转移)。放疗完成3月后评价,28(85%)例CR、4(12%)例PR、1例(3% )PD。1年总生存率100%,1年无病生存率91%。主要不良反应包括白细胞下降,血小板减少反应,肝功能损害,均可逆转。结论 PGC三药方案诱导化疗序贯同步放化疗治疗Ⅲ~ⅣA期鼻咽癌疗效较好,不良反应可耐受。

     

    Abstract: Objective To evaluate the efficacy and toxicities of PGC regimens (liposome paclitaxel, gemcitabine, carboplatin) followed by concurrent chemoradiotherapy in the treatment for patients with advanced nasopharyngeal carcinoma. Methods A total of 33 newly diagnosed patients with stage Ⅲ-Ⅳ A nasopharyngeal carcinoma were treated with two cycles of PGC neoadjuvant chemotherapy, followed by concurrent chemoradiotherapy. Neoadjuvant chemotherapy: liposomal paclitaxel 135 mg/m2 + gemcitabine 1 000 mg/m2 + carboplatin,area under the curve (AUC) of 5, D1, every 3 weeks. At the 7th week, all patients began to receive intensity modulated radiotherapy (IMRT) with carboplatin AUC of 5, every 3 weeks. Results After two cycles of PGC induction chemotherapy, 21%(7 cases) achieved complete remission (CR), 61%(21 cases) partial remission (PR), 12%(4 cases) stable disease (SD) and 3%(1 case) progress (multiple lung metastasis). Evaluation of completed reaction 3 months after radiotherapy showed that 85% (28 cases) was CR, 12% (4 cases) was PR and 3%(1 case) was PD. 1-year overall survival (OS) was 100%. 1-year disease free survival (DFS) was 91%. Major side effects were leukopenia, thrombocytopenia reactions and liver damage, which all could be reversed. Conclusion PGC induction chemotherapy combined concurrent chemoradiotherapy has good curative effect and tolerable side reaction in the treatment for stage Ⅲ~ⅣA nasopharyngeal carcinoma patients.

     

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