目的 探讨长春瑞滨联合奈达铂治疗顺铂耐药的晚期口腔颌面部肿瘤的疗效和安全性.方法 收集2012年8月至2015年7月一线接受以顺铂为基础的化疗失败的42例晚期口腔颌面部肿瘤患者,均给予长春瑞滨联合奈达铂方案化疗.长春瑞滨25 mg/m2静滴,d1、d8;奈达铂80 mg/m2静滴,d1、d2,21天为1个周期.采用RECIST l.1版标准评价近期疗效,NCI CTC 4.0版标准评价不良反应.结果 42例患者均可评价近期疗效,有效率为45.2％,疾病控制率为73.8％,中位无进展生存时间为7个月(95％CI:6.06～7.94个月),中位总生存时间为13个月(95％CI:10.91～ 15.09个月).主要毒副反应为骨髓抑制、恶心呕吐,1～2级居多.结论 长春瑞滨联合奈达铂治疗顺铂耐药的晚期口腔颌面部肿瘤疗效较好,耐受性好,安全性高,值得进一步临床观察和研究.%Objective To evaluate the clinical efficacy and safety of vinorelbine combined with nedaplatin for patients with cisplatin-resistant advanced oral and maxillofacial cancer.Methods From Aug 2012 to Jul 2015,42 advanced oral and maxillofacial cancer patients failed to the first-line cisplatin-based chemotherapy were treated with vinorelbine plus nedaplatin regimen.The regimen was taken as follow:vinorelbine 25 mg/m2 iv,d1,d s;nedaplatin 80 mg/m2 iv,d1,d2,21 days as 1 cycle.The efficacy and adverse effects were respectively evaluated by RECIST guideline(version 1.1) and NCI CTC 4.0 criteria.Results All patients were available for evaluation,the overall response rate was 45.2％,the disease control rate was 73.8％,the median overall survival was 13 months (95％CI:10.91-15.09 months),and the median progress free survival was 7 months (95％ CI:6.06-7.94 months).The common adverse effects were myelosuppression and nausea/vomitting,maily in grade 1-2.Conclusion Combination of vinorelbine and nedaplatin for patients with cisplatin-resistant advanced oral and maxillofacial cancer is effective and well-tolerated,and is deserved further clinical research.
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