【摘要】：目的分析根治性放療后發(fā)生遠(yuǎn)處轉(zhuǎn)移鼻咽癌患者化療和療效的臨床資料，為臨床選擇和實(shí)施適當(dāng)?shù)耐炀刃曰熖峁┮罁?jù)。 方法回顧性分析根治性放療后發(fā)生遠(yuǎn)處轉(zhuǎn)移鼻咽癌化療患者臨床資料，Kaplan-Meier法計(jì)算生存率，χ2檢驗(yàn)比較順鉑為基礎(chǔ)的雙藥聯(lián)合化療方案與奧沙利鉑為基礎(chǔ)的雙藥聯(lián)合化療方案、紫杉類+鉑類與吉西他濱+鉑類的有效率（RR）差別，Log-rank test比較治療到進(jìn)展的時(shí)間（TTP）差別。 結(jié)果全組114例患者，10例失訪，隨訪率91.2%。全組中位隨訪時(shí)間20個(gè)月（3～83個(gè)月），90例死亡，24例存活患者中位隨訪53.5個(gè)月（10～83個(gè)月）。全組中位生存時(shí)間20個(gè)月，1、2、3年生存率分別為66.5%、41.2%、27.2%。114例患者共化療511周期，順鉑為基礎(chǔ)的雙藥聯(lián)合化療方案RR為73.4%，奧沙利鉑為基礎(chǔ)的雙藥聯(lián)合化療方案RR為84.0%，兩者RR差別無(wú)統(tǒng)計(jì)學(xué)意義（P=0.136）,兩者中位TTP均為8個(gè)月；紫杉類+鉑類與吉西他濱+鉑類的RR分別為87.1%、86.0%，差別無(wú)統(tǒng)計(jì)學(xué)意義（P=0.865）,兩者中位TTP分別為7個(gè)月、12個(gè)月，差別無(wú)統(tǒng)計(jì)學(xué)意義（P=0.497）。 結(jié)論：對(duì)于根治性放療后局部和區(qū)域控制良好的遠(yuǎn)處轉(zhuǎn)移鼻咽癌患者，，順鉑為基礎(chǔ)的雙藥聯(lián)合化療方案與奧沙利鉑為基礎(chǔ)的雙藥聯(lián)合化療方案比較、紫杉類+鉑類與吉西他濱+鉑類比較，不管是有效率還是治療到進(jìn)展的時(shí)間，均無(wú)明顯差別。
[Abstract]:Objective to analyze the clinical data of chemotherapy and curative effect in patients with distant metastasis of nasopharyngeal carcinoma (NPC) after radical radiotherapy, and to provide evidence for clinical selection and implementation of appropriate rescue chemotherapy. Methods the clinical data of patients with distant metastasis of nasopharyngeal carcinoma (NPC) after radical radiotherapy were analyzed retrospectively. the survival rate was calculated by Kaplan-Meier method. The difference of the effective rate between taxoid platinum and gemcitabine platinum was compared between the combination chemotherapy regimen based on platinum and oxaliplatin, and the difference in the time (TTP) between the treatment and the progress of treatment by Log-rank test. Results of the 114 patients, 10 were lost, the follow-up rate was 91.2%. The median follow-up time was 20 months (3 鈮

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