摘要
目的探讨根治性同步放化疗后血浆EB病毒DNA持续升高的局部晚期鼻咽癌患者行卡培他滨节拍化疗的疗效及安全性。方法诱导化疗序贯根治性同步放化疗后8周血浆EB病毒DNA持续升高的局部晚期鼻咽癌患者53例,其中行卡培他滨节拍化疗(卡培他滨750 mg/m^(2),2次/d,连续2周后停用1周,21 d为1个周期,至少4个周期)者25例为节拍化疗组,未行后续治疗者28例为对照组,评估2组疗效及不良反应发生情况。随访至2022年2月10日,绘制Kaplan-Meier生存曲线,比较2组5年总生存率、无局部区域复发生存率、无远处转移生存率。结果节拍化疗组性别、年龄、T分期、N分期、临床分期、病理分级、ECOG评分与对照组比较差异均无统计学意义(P>0.05)。节拍化疗组5年总生存率(76.0%)、5年无局部区域复发生存率(79.3%)、5年无远处转移生存率(83.1%)均高于对照组(53.6%、46.4%、50.0%)(P<0.05)。节拍化疗组手足综合征发生率(100.0%)高于对照组(0)(χ^(2)=64.788,P<0.001),恶心呕吐、白细胞计数减少发生率与对照组比较差异均无统计学意义(P>0.05)。结论根治性同步放化疗后血浆EB病毒DNA持续升高的局部晚期鼻咽癌患者行卡培他滨节拍化疗可提高5年生存率,减少肿瘤复发及转移,不良反应可耐受,安全性好。
Objective To observe the clinical efficacy and safety of capecitabine metronomic chemotherapy for locally advanced nasopharyngeal carcinoma(NPC)in patients with persistently elevated plasma Epstein-Barr virus DNA(EBV DNA)after radical concurrent chemoradiotherapy.Methods The plasma EBV DNA levels were persistently elevated in 8 weeks after inductive chemotherapy and sequential and concurrent radiochemotherapy in 53 patients with locally advanced NPC,in which 25 were administered with oral metronomic capecitabine 750 mg/m^(2)body surface area,twice daily for 2 weeks of a 3-week cycle,a 21-day cycle for at least four cycles(metronomic chemotherapy group),and 28 patients received no metronomic chemotherapy(control group).The clinical efficacy and adverse reactions were assessed in two groups.The patients were followed up till February 10,2022.Kaplan-Meier survival curves were drawn to compare the 5-year overall survival,5-year local-regional recurrence-free survival and 5-year distant metastasis-free survival between two groups.Results There were no statistically significant differences in the gender,age,T stage,N stage,clinical stage,pathological grade and ECOG score between two groups(P>0.05).The 5-year overall survival,5-year local-regional recurrence-free survival and 5-year distant metastasis-free survival were higher in metronomic chemotherapy group(76.0%,79.3%,83.1%)than those in control group(53.6%,46.4%,50.0%)(P<0.05).The incidence of hand-foot syndrome was higher in metronomic chemotherapy group(100.0%)than that in control group(0)(χ^(2)=64.788,P<0.001),and there were no statistically significant differences in the incidences of nausea/vomiting and decreased white blood cell count between two groups(P>0.05).Conclusions Capecitabine metronomic chemotherapy can significantly improve the 5-year overall survival and reduce the recurrence and metastasis in locally advanced NPC patients with persistently elevated EBV-DNA after radical concurrent chemoradiotherapy,and it is safe and tolerable.
作者
李白羽
刘建波
朱庆尧
王跃伟
LI Bai-yu;LIU Jian-bo;ZHU Qing-yao;WANG Yue-wei(Cancer Center,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou,Henan 450003,China)
出处
《中华实用诊断与治疗杂志》
2023年第3期265-268,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划项目(201602245)。
关键词
鼻咽癌
局部
晚期
EB病毒DNA
卡培他滨节拍化疗
预后
nasopharyngeal carcinoma
locally
advanced
Epstein-Barr virus DNA
capecitabine metronomic chemotherapy
prognosis
