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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。
Objective To investigate the ORR and adverse reactions of neoadjuvant chemotherapy in locally advanced nasopharyngeal carcinoma (NPC) treated with TPS1 and to explore the possibility of TPS1 replacing neoadjuvant chemotherapy with TPF. Methods Twenty-nine patients with locally advanced nasopharyngeal carcinoma received concurrent chemoradiation after two cycles of neoadjuvant chemotherapy with TPS1. Results The median change of BMI (body mass index) after TPS1 neoadjuvant chemotherapy was 0.34 (ranged from 0 to 1.1), and the median BMI (body mass index) after radiotherapy plus chemotherapy was 1.1 (range, 0.73 to 2.11). Immediate neo-nasal chemotherapy after neoadjuvant chemotherapy evaluation: CR 4 cases (13.8%), PR 24 cases (82.8%), SD 1 case (3.4%), ORR 96.6%. Immediately after the overall radiotherapy and chemotherapy nasopharyngeal efficacy evaluation: CR 22 cases (75.9%), PR 7 cases (24.1%), ORR 100.0%. There was no grade 4 adverse reaction in the whole group after TPS1 neoadjuvant chemotherapy, with rare Grade 3 adverse reactions, mostly 0-1 grade adverse reactions, grade 2 reactions were mainly nausea (48.0%), vomiting (21.0%), leucopenia (24.0% ) And neutropenia (14.0%). The whole group after the end of chemotherapy without grade 4 adverse reactions, rare grade 3 adverse reactions (except oral mucositis). The main acute side effects are hematological toxicity, radiodermatitis, oral mucositis, dry mouth, hair loss and vomiting. Conclusion TPS1 neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma has good short-term curative effect and low toxicity, and TPS1 may be an alternative to TPF.