Page 115 - 《中国药房》2022年5期

·药物与临床·

白蛋白结合型紫杉醇联合奈达铂诱导化疗对局部晚期鼻咽癌的

影响 Δ

王 峰 ，王 颖，龙 斌，舒小镭，李 丛，李晓宇（重庆大学附属肿瘤医院肿瘤放射治疗中心，重庆 400030）
＊

中图分类号 R739.63；R969.4；R979.1 文献标志码 A 文章编号 1001-0408（2022）05-0617-05
DOI 10.6039/j.issn.1001-0408.2022.05.18

摘 要 目的 观察白蛋白结合型紫杉醇联合奈达铂诱导化疗后再行同步放化疗治疗局部晚期鼻咽癌的临床效果和安全性。方
法 回顾性分析我院2017年8月－2018年7月接受白蛋白结合型紫杉醇联合奈达铂诱导化疗的局部晚期鼻咽癌（Ⅲ/Ⅳa期）患者
临床资料（观察组，45例），采用倾向性评分匹配同期完成多西他赛联合顺铂及氟尿嘧啶方案诱导化疗的局部晚期鼻咽癌患者（对
照组，45例）。诱导化疗后两组患者均采用调强放射治疗，观察组采用奈达铂同步化疗，对照组采用顺铂同步化疗。对两组患者
的临床效果和不良反应发生情况进行比较。结果 所有患者均完成治疗及3年随访。诱导化疗后及同步放化疗1、3个月后，两组
患者的近期疗效比较，差异均无统计学意义（P＞0.05）；两组患者的3年局部肿瘤控制率和3年无远处转移生存率比较，差异均无
统计学意义（P＞0.05）。观察组患者的白细胞减少（3 级及以上）发生率显著低于对照组，周围神经毒性发生率显著高于对照组
（P＜0.05）；观察组患者血小板减少（2级及以上）、皮疹、呕吐（2级及以上）等发生率较对照组低，但差异无统计学意义（P＞0.05）；
两组患者其他不良反应发生率相差不大，组间比较差异无统计学意义（P＞0.05）。结论 白蛋白结合型紫杉醇联合奈达铂诱导化疗
后再行同步放化疗治疗局部晚期鼻咽癌的疗效确切且不良反应可耐受。
关键词 白蛋白结合型紫杉醇；奈达铂；局部晚期鼻咽癌；诱导化疗；同步放化疗；疗效；安全性

Effects of albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy on loco-regionally
advanced nasopharyngeal carcinoma
WANG Feng，WANG Ying，LONG Bin，SHU Xiaolei，LI Cong，LI Xiaoyu（Cancer Radiotherapy Center，
Chongqing University Cancer Hospital，Chongqing 400030，China）

ABSTRACT OBJECTIVE To observe the clinical efficacy and safety of albumin-bound paclitaxel combined with nedaplatin
inductive chemotherapy followed by concurrent radiochemotherapy in the treatment of loco-regionally advanced nasopharyngeal
carcinoma. METHODS The clinical data of 45 patients （observation group） with loco-regionally advanced nasopharyngeal
carcinoma（Ⅲ/Ⅳa stage）who received albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy in our hospital
from August 2017 to July 2018 were retrospectively analyzed. Propensity score was used to match 45 patients（control group）with
loco-regionally advanced nasopharyngeal carcinoma who received docetaxel combined with cisplatin and fluorouracil inductive
chemotherapy. After inductive chemotherapy，both groups received intensity-modulated radiochemotherapy（IMRT）；observation
group was additionally given concurrent nedaplatin chemotherapy，and control groups was given concurrent cisplatin chemotherapy.
Clinical efficacy and the incidence of ADR were compared between 2 groups. RESULTS All patients completed treatment and
3-year follow-up. After inductive chemotherapy and 1，3 months after concurrent radiochemotherapy，there was no statistical
significance in short-term response between 2 groups（P＞0.05）. There was no significantly difference in 3-years local control rate
and 3-years free from distant metastasis between 2 groups（P＞0.05）. The incidences of leucopenia（grade 3 or above）in the
observation group were significantly lower than those in the control group，and the incidence of peripheral neuropathy in
observation group was higher than that in control group（P＜0.05）. The incidences of thrombocytopenia（grade 2 or above），rash
and vomiting（grade 2 or above）in the observation group were lower than those in the control group，but the difference was not
statistically significant（P＞0.05）. There was no significant difference in the incidence of other ADR between 2 groups（P＞0.05）.
CONCLUSIONS Albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent
chemoradiotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma is effective and tolerable．
KEYWORDS albumin-bound paclitaxel；nedaplatin；loco-regionally advanced nasopharyngeal carcinoma；inductive chemotherapy；
concurrent chemoradiotherapy；efficacy；safety

我国鼻咽癌患者占全球鼻咽癌患者数量近一半，主
Δ 基金项目：重庆市科卫联合医学科研项目（No.2021MSXM160）
[1]
＊住院医师，硕士。研究方向：头颈部肿瘤综合治疗。电话： 要发病区域集中在华南地区 。近年来，随着医学技术
023-65079223。E-mail：346634451@qq.com 的发展和进步，鼻咽癌患者的总体生存率大幅度提升，

中国药房 2022年第33卷第5期 China Pharmacy 2022 Vol. 33 No. 5 ·617 ·