目的:观察重组人血管内皮抑素联合化疗治疗晚期头颈部癌的疗效及安全性.方法:22例综合治疗后出现转移的晚期头颈部癌患者,接受恩度联合化疗的治疗方案.重组人血管内皮抑素(恩度)12～15mg/d,d1～d14,21d为1周期；卡培他滨1500～2000mg/(m2·d),d1～d14,或替吉奥120mg/d,d1～d14,21d为1周期.每周期评价毒副反应,每2周期评价疗效,稳定和有效者继续治疗2～4周期.结果:22例患者共接受108个周期的化疗,中位4个周期,完全缓解(CR)0例,部分缓解(PR)2例,稳定(SD)14例,进展(PD)6例,总有效率RR (CR+PR)为9.09％,疾病控制率DCR (CR+PR+SD)为72.7％.中位疾病进展时间10个月,中位生存时间16个月.生活质量评价19例患者有不同程度的改善.与恩度相关的毒副反应主要为轻度的心脏毒副反应,包括T波和ST-T改变、轻度高血压,其它毒副反应与化疗药物相关.结论:血管内皮抑素联合卡培他滨或替吉奥治疗晚期头颈部癌具有一定疗效,可以改善患者的QOL、毒性低、安全性良好.%Objective:To observe the clinical efficacy and safety of Rh-endostatin /Endostar,a new molecular targeted antitumor agent, combined with chemotherapy on metastatic head and neck neoplasms. Methods: 22 cases of metastatic head and neck neoplasms confirmed by histopathology or cytopathology were administered of 12 ~ 15mg Rh-endostatin /Endostar from dayl to dayl4. The chemotherapy agents were: capecitabine 1500~2000mg/(m2·d) ,dl-dl4,or TS-1 120mg/d, dl-dl4,21 days was 1 cycle. The toxicity was evaluated after 1 cycle and the efficacy was evaluated after 2 cycles. Results :22cases completed 108 cycles with a median 4 cycles. There was no case achieved CR,2 cases achieved PR, 9 cases were SD and 6 cases were PD, overall response rate(RR = CR+PR) was 9. 09%,and disease control rate DCRCCR + PR+SD) was 72. 7%. The quality of life (QOL) were improved in 19 cases(86. 3%). The median TTP was 10 months and the median survival time was 16 months. The main toxicities related to endostar was mildly cardiac toxicity (ECG T wave and ST-T changes, mild hypertension) in 3cases, other toxicities were related to chemotherapy gents. Conclusion:There are better efficacy of endostar combined with the related chemotherapy on the metastatic head and neck neoplasms and QOL of such patients may be improved with low toxic and good safety,so it seems to be an effective salvage regime.
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