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目的分析多烯紫杉醇联合顺铂治疗原发灶不明癌的疗效。方法回顾性分析了2010年1月至2011年2月期间收治的15例原发灶不明癌患者,均未经过化疗,PS评分0-2,有可测量病灶,无器官功能障碍。方案:多烯紫杉醇60mg/m2,d1,静脉化疗,每21天为一个周期,每2个周期后评价疗效。病情未出现进展者共完成4～6个周期。结果 15例患者中有1例因经济原因仅化疗1个周期,其余14例患者总有效率为50%,95%可信区间23%～77%,疾病控制率为78.6%,95%可信区间49%-98%;中位进展时间为5.5个月,中位生存时间为11.6个月;无化疗相关性死亡,常见的不良反应为白细胞减少(1～3人),恶心呕吐(1～2级11人),肾毒性(1～2级3人),外周神经毒性(1级3人),肝脏毒性(1～2级3人),心脏毒性(1级1人)。结论多烯紫杉醇联合顺铂治疗原发灶不明转移癌安全有效,不良反应可以耐受。
Objective To analyze the efficacy of docetaxel combined with cisplatin in the treatment of unidentified primary cancer. Methods We retrospectively analyzed 15 patients with unidentifiable primary tumor who were admitted between January 2010 and February 2011. All patients had no chemotherapy, PS score 0-2, measurable lesions, and no organ dysfunction. Protocol: Docetaxel 60 mg/m2, d1, intravenous chemotherapy, every 21 days as a cycle, and the efficacy was evaluated after every 2 cycles. A total of 4 to 6 cycles were completed without progress. Results One of the 15 patients had only one cycle of chemotherapy for economic reasons. The remaining 14 patients had a total effective rate of 50%, a 95% confidence interval of 23% to 77%, a disease control rate of 78.6%, and 95% confidence. Interval 49%-98%; median progression time 5.5 months, median survival time 11.6 months; no chemotherapy-related death, common adverse reactions were leukopenia (1 to 3 people), nausea and vomiting (1 to Grade II 11), nephrotoxicity (Grade 1 to 3), peripheral neurotoxicity (Grade 3), liver toxicity (grade 1 to 3), cardiotoxicity (Grade 1). Conclusions Docetaxel combined with cisplatin is safe and effective in the treatment of primary metastases of unknown origin, and adverse reactions can be tolerated.