Cisplatin and 5-FU in the Treatment of Nasopharyngeal Carcinoma with Distant Metastasis or Recurrence

以Cisplatin和5-FU治療有遠隔轉移或復發之鼻咽癌

柯政郁(Jenq-Yuh Ko) ； 張燕良(Yen-Liang Chang) ； 徐茂銘(Mow-Ming Hsu)

《中華民國耳鼻喉科醫學會雜誌》 28卷5期 (1993/10) Pp. 318-324

https://doi.org/10.6286/1993.28.5.318

摘要

為評估化學治療對有遠隔轉移與 / 或局部區域復發之鼻咽癌的效應，吾人從1989年1月到1990年6月，以Cisplatin 100 mg/m2快速滴注，緊接著5-FU 1000 mg/m2 / 天持續靜脈滴注，計5天(稱為PF I)，治療35個病人。後來為了減輕毒性及治療之初不立即引起嘔吐，吾人將處方改為先以5-FU 750 mg/m2/ 天持續靜注兩天，接著用Cisplatin 100 mg/m2快速滴注，再接5-FU 750 mg/m2/ 天計3天(稱為 PE II)。 從1990年7月到1991年12月，共有22人接受PF II治療。以PE I 治療經放射線治療過而有復發與/或遠隔轉移者之反應率為 20% ，對以前沒治療過的遠隔轉移病人之反應率為60%。以PE II治療之結果，分別是38 %及83 %。用前兩種處方治療所得的有效反應期間之中位數分別是5個月及6個月。副作用包括腎毒性，骨髓功能受抑制、噁心、嘔吐及下痢，但絕大部分不超過第二度，並沒有發生聽力更惡化的情形。吾人的結果顯示Cisplatin和 5-FU對於放射線治療過而有復發與/或遠隔轉移的鼻咽癌病人之效果不好，但對於以前沒治療過的遠隔轉移病人效果很好。改變Cisplatin和5-FU的給藥順序，再本研究並不影響其效果。

並列摘要

To evaluate the effect of chemotherapy in nasopharyngeal carcinoma (NPC) patients with distant metastasis and/or locoregional recurrence, we treated 35 patients from January 1989 to June 1990 with cisplatim 100 mg/m2 followed by 5-FU 1000 mg/m2/day continuous infusion for 5 days (PF I). For reducing toxicities and not inducing vomiting at the beginning of ther-apy, we later changed the protocol to 5-FU 750 mg/m2/day continuous infu-sion for 2 days, followed by cisplatine 100 mg/m2 rapid infusion and 5-FU 750 mg/m2/day for another 3 days (PE II). Twenty-two patients were enrolled from July 1990 to December 1991 using the latter protocol. With PF I，the response rates were 20 % in irradiated patients with recurrence and/or distant metastasis and 60 % in the previously untreated patients with distant metastasis. With PF II protocol, the response rates were 38 % and 83 % respectively. The median durations of response were 5 months and 6 months respectively with the two protocols. Side effects included nephrotoxic-ity, myelosuppression, nausea, vomiting and diarrhea, and most of them were not beyond grade 2. No hearing impairment was noted. Our results show poor response of cisplatin and 5-FU in the irradiated NPC patients with recurrence and/or distant metastasis, and good response in the previ-ously untreated cases with distant metastais. Changing the administration sequence of cisplatin and 5-FU does not influence the response in this study.

並列關鍵字

nasopharyngeal carcinoma ； cisplatin ； 5-FU