TPS1新辅助化疗对局部晚期鼻咽癌的疗效观察

目的 研究局部晚期鼻咽癌使用TPS1新辅助化疗的ORR及不良反应,探讨TPS1替代TPF新辅助化疗的可能性.方法 对29例局部晚期鼻咽癌,使用TPS1新辅助化疗2个周期后行同步放化疗.结果 TPS1新辅助化疗后BMI(体重指数)变化中位数0.34(0~1.1),总体放化疗后BMI(体重指数)变化中位数1.1(0.73~2.11).新辅助化疗后鼻咽部即时疗效评价:CR 4例(13.8%),PR 24例(82.8%),SD 1例(3.4%),ORR 96.6%.总体放化疗后鼻咽部即时疗效评价:CR 22例(75.9%),PR 7例(24.1%),ORR 100.0%.TPS1新辅助化疗后全组无4级不良反应,罕见3级不良反应,大多为0~1级不良反应,2级反应主要为恶心(48.0%),呕吐(21.0%),白细胞减少(24.0%)和中性粒细胞减少(14.0%).整体放化疗结束后全组无4级不良反应,少见3级不良反应(口腔黏膜炎除外).主要急性毒副作用表现为血液毒性,放射性皮炎,口腔黏膜炎,口干,脱发和呕吐.结论 对局部晚期鼻咽癌使用TPS1新辅助化疗有很好的近期疗效及较低的毒副反应,TPS1有替代TPF方案的可能.

Clinical Observation of TPS1 Neoadjuvant Chemotherapy for Patients with Locally Advanced Nasopharyngeal Carcinoma

Objective To investigate the ORR and toxicity of TPS1 neoadjuvant chemotherapy for locally advanced naso-pharyngeal carcinoma,and to explore the possibility of replacing TPF with TPS1. Methods 29 patients with locally advanced na-sopharyngeal carcinoma were treated with TPS1 neoadjuvant chemotherapy for 2 cycles followed by concurrent chemoradiotherapy. Results The median change of BMI (body mass index) after neoadjuvant chemotherapy with TPS1 was 0. 34 (0 ~1. 1),the median change of BMI was 1. 1 (0. 73~2. 11) after overall treatment. Immediate effect of nasopharyngeal region after TPS1 neo-adjuvant chemotherapy,the CR,PR,SD and ORR were 13. 8%,82. 8%,3. 4% and 96. 6%,respectively. Immediate effect of na-sopharyngeal region after overall treatment,the CR,PR and ORR were 75. 9%,24. 1% and 100. 0%,respectively. After TPS1 neoadjuvant chemotherapy,the maximum toxxicity were no grade 4 toxicities,grade 3 rarely,mostly concentrated in grade 0~1,2 grade mainly concentrated in nausea (48. 0%) and vomiting (21. 0%),leukopenia (24. 0%) and neutropenia (14. 0%). After Overall treatment,the maximum toxicity were no grade 4 toxicities,rare grade 3 ( except for oral mucosal inflammation) . The main acute toxicity was mainly hematological toxicity,radiation dermatitis,oral mucositis,dry mouth,vomiting and hair loss. Conclusion TPS1 neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma achieved good treatment response with low toxici-ty,and the TPS1 has the potential to replace the TPF regimen.