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目的观察奈达铂联合方案治疗顺铂耐药的晚期鼻咽癌的疗效及毒性反应。方法对15例根治性放疗后远处转移并经含顺铂方案多程治疗失败的晚期鼻咽癌,予奈达铂联合方案化疗,化疗Ⅱ周期或以上者,评价客观疗效,全部病例评价毒副反应。结果15例中没有CR病例,有效率(RR)66.7%。疾病进展时间(TTP)2～8个月,中位疾病进展时间为4.5个月。15例共接受38个周期化疗,主要毒性反应为骨髓抑制,Ⅰ、Ⅱ度白细胞下降为47.4%,Ⅲ度为52.6%;Ⅰ、Ⅱ度血小板下降为52.6%,没有Ⅲ、Ⅳ度血小板下降,恶心呕吐反应轻微。结论奈达铂与顺铂无完全交叉耐药,对顺铂治疗失效的晚期鼻咽癌仍然有效,毒性反应可耐受,值得临床扩大使用。
Objective To observe the efficacy and toxicity of nedaplatin combined with cisplatin-resistant advanced nasopharyngeal carcinoma (NPC). Methods Fifteen patients with advanced nasopharyngeal carcinoma who were distantly metastasized after radical radiotherapy and failed to receive cisplatin regimen for multiple courses of chemotherapy were treated with nedaplatin combined with chemotherapy or chemotherapy for two cycles or more to evaluate the objective efficacy. All patients were evaluated for toxicity side effects. Results There were no CR cases in 15 cases and the effective rate (RR) was 66.7%. Disease progression time (TTP) 2 to 8 months, median disease progression time of 4.5 months. 15 cases received 38 cycles of chemotherapy, the main toxicity was myelosuppression, Ⅰ, Ⅱ leukopenia was 47.4%, Ⅲ degree was 52.6%; Ⅰ, Ⅱ degree of thrombocytopenia was 52.6%, there is no Ⅲ, Ⅳ degree of platelet decline, Nausea and vomiting minor reactions. Conclusion Nedaplatin has no cross-resistance with cisplatin, is still effective for the treatment of advanced nasopharyngeal carcinoma in which cisplatin is refractory, and the toxic reaction is tolerable and worthy of clinical expansion.