洛拉曲克联合顺铂治疗转移性鼻咽癌的临床观察

目的 观察洛拉曲克联合顺铂方案（LP）与氟尿嘧啶（5-FU）联合顺铂方案（FP）治疗转移性鼻咽癌（NPC）的疗效及不良反应。方法 收集2005年10月至2011年3月转移性NPC患者33例，按1∶1随机分为LP组（n=16）和FP组（n=17）。LP组：洛拉曲克 740mg／m2持续静滴120h，d1～d5；顺铂 25mg／m2静滴，d2～d4。FP组：5-FU 600mg／m2持续静滴120h，d1～d5；顺铂 25mg／m2静滴， d2～d4。两组均21天为1周期，治疗2～6个周期。 结果 LP组和FP组的有效率、疾病控制率、中位疾病进展时间和中位生存期分别为31.3％和35.3％、68.8％和76.5％、3.4个月和3.8个月、9.5个月和10.0个月，差异均无统计学意义（P＞0.05）。两组不良反应多为1～2级，LP组口腔黏膜炎的发生率低于FP组（P＜0.05），其他不良反应两组均无显著差异。结论 LP方案治疗转移性NPC与FP方案疗效相当，口腔不良反应较FP方案低，有望成为晚期NPC的一线治疗方案之一。

Efficacy of nolatrexed plus cisplatin in the treatment of metastatic nasopharyngeal carcinoma

Objective To compare the clinical efficacy and toxicity of nolatrexed plus cisplatin （ LP regimen） versus fluorouracil plus cisplatin （FP regimen） in the treatment of metastatic nasopharyngeal careinoma（NPC）. Methods Thirty-three eases of metastatic NPC patients from October 2005 to March 2011 were collected and randomly divided into LP regimen and FP regimen according to 1： 1. Sixteen patients and seventeen patients were treated with LP regimen and FP regimen, respectively. LP regimen：nolatrexed 740mg/m^2 eiv 120h d1-d5 ;eisplatin 25mg/m^2 iv d2-d4 ;FP regimen： fluorouracil 600mg/m^2 civ 120h d1-d5; cisplatin 25mg/m^2 iv d2-d4. The two regimens were repeated every three weeks and lasted for 2 to 6 cycles. Results The response rate,disease control rate,the median time to progress and the median overall survival of LP regimen and FP regimen were 31.3% and 35.3% , 68.8% and 76. 5% , 3.4 months and 3.8 months, and 9.5 months and 10. 0 months without significance between the two regimens （ P 〉 0. 05 ）. Toxicity of the two regimens were mainly in grade 1-2, oral toxicity of LP regimen was significantly lower than that of the FP regimen （ P 〈 0. 05 ） and other toxicities between the two groups had no differences. Conclusion The efficacy of LP regimen is similar to that of FP regimen,but the oral toxicity of LP regimen is much lower than that of FP regimen. LP regimen is expected to become one of the first-line regimens for metastatic NPC.