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目的：探索高剂量强度非铂类联合化疗方案对鼻咽癌远处转移的近期疗效，及多疗程巩固交替的治疗方法在鼻咽癌远处转移治疗中的价值。材料及方法：共收治鼻咽癌远处转移患者１７例。全部病例第一、二疗程均使用紫杉醇＋异环磷酰胺（ＰＩ）联合化疗。其后再选择不同的联合化疗方案，每种连用２３个疗程交替化疗至６８疗程。３周为一疗程。结果：两程ＰＩ方案总有效率约８２％，其中ＣＲ１２％；ＰＲ７０％。所有病例均发生骨髓抑制、脱发。其它不良反应轻微。６８程化疗耐受性良好，再获ＰＲ４例，１０例ＳＤ；１例原ＰＤ患者病情继续进展。目前２例死亡，３例病情进展，其它患者均已随访２９个月无进展，截止９８年１０月中位生存期９±２５个月。结论：高剂量强度ＰＩ方案对鼻咽癌远处转移有较好疗效，不良反应可以耐受。多方案交替、多疗程巩固化疗有利于改善预后。
OBJECTIVE: To explore the short-term curative effect of high-dose non-platinum combined chemotherapy on distant metastasis of nasopharyngeal carcinoma and the value of multi-treatment consolidation alternate therapy in the treatment of distant metastasis of nasopharyngeal carcinoma. Materials and Methods: A total of 17 patients with distant metastasis of nasopharyngeal carcinoma were treated. All cases of the first and second courses are used paclitaxel + ifosfamide (PI) combined with chemotherapy. Then choose a different combination of chemotherapy, each with 2 3 courses alternately chemotherapy to 6 8 courses. 3 weeks for a course of treatment. Results: The total effective rate of two-way PI was about 82%, of which CR12% and PR70%. In all cases, myelosuppression and hair loss occurred. Other adverse reactions minor. 6 8-course chemotherapy was well tolerated, obtained another PR4 cases, 10 cases of SD; 1 case of the original PD patients continued to progress. At present, 2 patients died and 3 patients progressed. Other patients were followed up for 2 to 9 months without progress. By October 1998, the median survival time was 9 ± 2.5 months. Conclusion: The high-dose intensity PI regimen has a good effect on the distant metastasis of nasopharyngeal carcinoma, and the adverse reaction can be tolerated. Multi-program alternating, multi-course consolidation chemotherapy is conducive to improving the prognosis.