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目的 研究铂类治疗耐药的晚期、复发的鼻咽癌的救援治疗方案。方法 入选４２ 例铂类治疗耐药的晚期、复发的鼻咽癌，应用吡喃阿霉素（ＴＨＰＡＤＭ） 及长春酰胺（ＶＤＳ） 联合化疗方案进行救援治疗，用药方法为ＴＨＰＡＤＭ５０ ｍｇ／ｍ２，静注，第１ 天，ＶＤＳ３ ｍｇ／ｍ２ ，静注，第１，５ 天，每３ 周为一疗程。结果 总有效率为２８．２％ （１１／３９） ，对ＤＤＰ或卡铂初治有效后继发耐药的病人有效率达３９．１％ （９／２３），而对ＤＤＰ或卡铂原发耐药的病例有效率则较低。该方案毒性较低，病人易耐受。结论 ＴＨＰＡＤＭ 联合ＶＤＳ方案对铂类继发耐药的鼻咽癌病人有一定的救援治疗价值。
Objective To study the rescue and treatment of advanced and recurrent nasopharyngeal carcinoma resistant to platinum. Methods Forty-two patients with advanced and relapsed nasopharyngeal carcinoma were enrolled in the study. Forty patients were treated with THPADM and VDS combined with chemotherapy regimen. The treatment was THPADM 50 mg / m2, intravenous injection, the first day, VDS3 mg / m2, intravenous injection, the first 1,5 days, every 3 weeks for a course of treatment. Results The total effective rate was 28.2% (11/39). The effective rate was 39.1% (9/23) in DDP or carboplatin-naive and secondary drug-resistant patients, but not in DDP or carboplatin Drug resistant cases are less effective. The program toxicity is low, the patient is easy to tolerate. Conclusion THP ADM combined with VDS regimen in patients with platinum-resistant nasopharyngeal carcinoma have some rescue and treatment value.