紫杉醇脂质体与传统紫杉醇治疗晚期鼻咽癌的疗效分析

目的比较紫杉醇脂质体和传统紫杉醇联合卡铂一线治疗晚期鼻咽癌的疗效及毒性。方法回顾性分析2010年1月-2011年12月我院晚期鼻咽癌的一线治疗患者临床资料,72例晚期鼻咽癌患者被分为实验组和对照组,实验组（35例）应用紫杉醇脂质体,而对照组（37例）应用普通紫杉醇,每次剂量均为135-175mg/m2;两组均联合卡铂,采用AUC=5。每21d为1个周期,每2个周期评价疗效1次。结果 72例患者共接受341个周期化疗,所有患者均可评价疗效。实验组总有效率为71.4%,对照组为70.3%,两者之间无统计学差异。两组血液学及消化道毒性相似,而在由溶媒所产生的相关毒性方面,紫杉醇（对照组）明显高于紫杉醇脂质体（实验组）。结论与传统紫杉醇联合卡铂一线治疗晚期鼻咽癌相比,紫杉醇脂质体联合卡铂方案疗效相似,但由溶媒所产生的毒性更低,且使用方便,值得临床推广应用。

Efficacy analysis of Paclitaxel liposome and traditional Paclitaxel plus carboplatin in the first-line chemotherapy on advanced nasopharyngeal carcinoma

Objective To evaluate the efficacy and toxicity of Paclitaxel liposome or traditional Paclitaxel plus carboplatin in the first-line chemotherapy on advanced nasopharyngeal carcinoma.Methods 72 cases of advanced nasopharyngeal carcinoma patients were treated in our hospital from January 2009 to December 2010.They were divided into experimental group and control group according to chemotherapy regimen.The experimental group（35 cases） received Paclitaxel liposome 135-175 mg/m2,and the control group（37 cases） received the traditional use of Paclitaxel 135-175 mg/m2.Carboplatin were given to both groups,with AUC=5.Treatment was adminisered every 3 weeks.Efficacy and toxicity were evaluated by RECIST every 2 cycles.Results 72 cases received a total of 341 cycles of chemotherapy,and all were evaluable for efficacy and toxicity.The overall response rates were 71.4% and 70.3% in the experimental group and control group,respectively.The efficacy was not statistically significant between the two groups.Toxicity of allergic reaction to solvent in traditional Paclitaxel（control group） was significantly higher than that of Paclitaxel liposome（experimental group）,while other adverse reactions such as hematological and gastrointestinal toxicity were similar in both groups.Conclusion The efficacy of Paclitaxel liposome combined with Carboplatin as first-line treatment in advanced nasopharyngeal carcinoma maybe similar with that of traditional Paclitaxel combined with Carboplatin,but it is worthy of clinical application for its lower toxicity induced by its solvent and convenience of usage.