洛铂联合放疗治疗局部-区域晚期鼻咽癌的剂量递增试验

中华放射肿瘤学杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2020.03.003

X. Pang, D. Qing, Bin Zhao, D. Ma

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引用次数: 0

摘要

目的探讨洛铂联合放射治疗局部晚期鼻咽癌(NPC)的最大耐受剂量(MTD)。方法选取18例Ⅲ/IV期鼻咽癌患者。所有LBP剂量增加的患者均给予同步放化疗。LBP的初始剂量为15mg /m2，逐渐增加至5mg /m2。每组至少3例。如果在达到MTD之前没有发生剂量限制性毒性(DLT)，则患者进入下一剂量组。定期评价疗效和毒性。结果10 mg/m2组3例，15 mg/m2组3例，20 mg/m2组和25 mg/m2组6例。25 mg/m2组2例患者出现DLT。因此，测定MTD为20 mg/m2。相应治疗3个月后，患者鼻咽肿瘤及颈阳性淋巴结的缓解率为100%。最常见的毒性是可逆的骨髓抑制。结论局部晚期鼻咽癌患者每周洛铂联合IMRT的MTD为20 mg/m2。该方案可靠、安全，值得进一步临床研究。关键词:鼻咽肿瘤/同步放化疗;Lobaplatin;Dose-limiting毒性;最大耐受剂量

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Dose-escalation trial of lobaplatin weekly plus concurrent radiotherapy for local-regionally advanced nasopharyngeal carcinoma

Objective To define the maximum-tolerated dose (MTD) of lobaplatin (LBP) in a weekly regimen combined with concurrent radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 18 cases with stage Ⅲ/IV A NPC were enrolled. Concurrent chemoradiotherapy was given to all the patients with a dose escalation of LBP. The initial dose of LBP was 15 mg/m2 with an escalating dose of 5 mg/m2. At least 3 patients were assigned into each group. Patients were proceeded into the next dose group if no dose-limiting toxicity (DLT) occurred until the MTD was achieved. Efficacy and toxicity were evaluated regularly. Results Three patients were assigned into the 10 mg/m2, 3 into the 15 mg/m2, and 6 into the 20 mg/m2 and 25 mg/m2 groups, respectively. Two patients experienced DLT in the 25 mg/m2 group. Hence, the MTD was determined as 20 mg/m2. At 3 months after corresponding treatment, the remission rate of nasopharyngeal tumors and neck-positive lymph nodes of the patients was 100%. The most common toxicity was reversible bone marrow suppression. Conclusions The MTD of weekly lobaplatin plus concurrent IMRT is 20 mg/m2 for locally advanced NPC. This regimen is reliable and safe, which is worthy of further clinical study. Key words: Nasopharyngeal neoplasm/concurrent chemoradiotherapy; Lobaplatin; Dose-limiting toxicity; Maximum tolerated dose

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来源期刊

中华放射肿瘤学杂志

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发文量

6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.