童艳丽 梅清华 曾泗宇 杨水源

[摘要]目的 觀察白蛋白结合型紫杉醇联合奈达铂治疗晚期复发鼻咽癌的临床效果和安全性。方法 回顾性分析2016年8月～2019年6月我院鼻咽癌晚期复发后接受紫杉醇类药物联合铂类化疗的78例患者的临床资料，将白蛋白结合型紫杉醇联合奈达铂化疗的患者作为观察组，将普通紫杉醇注射液联合奈达铂化疗的患者作为对照组，每组各39例。化疗4个周期后对两组患者的近期疗效、不良反应发生情况进行评估。结果 化疗4周期后，观察组患者的总缓解率高于对照组，差异有统计学意义（P<0.05）。两组患者的血液学毒性发生率比较，差异无统计学意义（P>0.05）;非血液学毒性方面，观察组患者的皮疹、面部潮红和周围神经毒性发生率均低于对照组，差异有统计学意义（P<0.05）;两组患者的恶心呕吐发生率比较，差异无统计学意义（P>0.05）。结论 对晚期复发鼻咽癌患者给予白蛋白紫杉醇联合奈达铂化疗，具有较好的临床效果，皮疹、面部潮红等过敏反应少，耐受性好。

[关键词]白蛋白结合型紫杉醇;鼻咽癌;化疗

[中图分类号] R739.6          [文献标识码] A          [文章编号] 1674-4721（2020）7（a）-0004-04

Clinical effect and safety of Albumin-bound Paclitaxel combined with Nedaplatin in the treatment of advanced recurrent nasopharyngeal carcinoma

TONG Yan-li   MEI Qing-hua   ZENG Si-yu   YANG Shui-yuan

Department of Pharmacy， Guangdong Second Provincial General Hospital， Guangzhou   510317， China

[Abstract] Objective To observe the clinical effect and safety of Albumin-bound Paclitaxel combined with Nedaplatin in the treatment of advanced recurrent nasopharyngeal carcinoma. Methods The clinical data of 78 patients who received Paclitaxel combined with Platinum for chemotherapy after relapse of advanced nasopharyngeal carcinoma in our hospital from August 2016 to June 2019 were retrospectively analyzed. Patients with Albumin-bound Paclitaxel combined with Nedaplatin for chemotherapy were used as the observation group， and patients with common Paclitaxel Injection combined with Nedaplatin for chemotherapy were used as the control group， with 39 cases in each group. After 4 cycles of chemotherapy， the short-term efficacy and incidence of adverse reactions in the two groups of patients were evaluated. Results After 4 cycles of chemotherapy， the total remission rate of the observation group was higher than that of the control group， and the difference was statistically significant （P<0.05）. There was no statistically significant difference in the incidence of hematological toxicity between the two groups （P>0.05）. In terms of non-hematological toxicity， the incidence rates of skin rash， facial flushing and peripheral neurotoxicity in the observation group were lower than those in the control group， and the differences were statistically significant （P<0.05）. There was no statistically significant difference in the incidence rate of nausea and vomiting between the two groups （P>0.05）. Conclusion Albumin-bound Paclitaxel combined with Nedaplatin in the chemotherapy of advanced recurrent nasopharyngeal carcinoma has good clinical effect， with fewer allergic reactions such as skin rash and facial flushing， and good tolerance.

[Key words] Albumin-bound Paclitaxel; Nasopharyngeal carcinoma; Chemotherapy

鼻咽癌是我国南方常见的恶性肿瘤，大约5%的患者诊断时即为晚期[1]，虽然局部控制率目前有所改善，但远期转移是晚期复发患者的主要原因[2]。对于晚期复发鼻咽癌患者，全身化疗是主要治疗手段，紫杉醇类药物联合铂类化合物是晚期鼻咽癌化疗的方案之一[3-4]。由于紫杉醇水溶性低，制备普通注射液时添加了聚氧乙基蓖麻油作为助溶剂，因此在输注时容易引起过敏反应。而白蛋白结合型紫杉醇是一种新型的紫杉醇剂型，以纳米微粒白蛋白为载体，不仅改变了助溶剂，也明显提高疗效，减少不良反应，其在临床上主要应用于乳腺癌[5-6]、非小细胞肺癌[7]、胰腺癌[8]和黑色素瘤[9]。……