紫杉醇、紫杉醇脂质体和白蛋白结合型紫杉醇在头颈肿瘤中的疗效比较

Comparison of the Efficacy of Paclitaxel, Paclitaxel Liposome and Albumin Bound Paclitaxel in Head and Neck Tumors

关键词:  紫杉醇  紫杉醇脂质体  白蛋白结合型紫杉醇  头颈肿瘤

Key words:  paclitaxel(PTX)  paclitaxel liposome(L-PTX)  albumin bound paclitaxel(nab-PTX)  head and neck tumors

摘要:

目的 探讨紫杉醇（paclitaxel，PTX）、PTX脂质体（paclitaxel liposome，L-PTX）和白蛋白结合型PTX（albumin bound paclitaxel，nab-PTX）在头颈肿瘤中的疗效。方法 采用回顾性研究，收集整理2017年1月-2018年6月69例宁波市医疗中心李惠利医院头颈恶性肿瘤患者的临床资料，其中31例PTX联合卡铂治疗为PTX组，26例L-PTX联合卡铂治疗为L-PTX组，12例nab-PTX联合卡铂治疗为nab-PTX组。比较3组患者近期临床疗效以及不良反应情况。结果 Nab-PTX组患者的近期疗效优于PTX组（66.67%vs 32.26%，χ²=4.209，P=0.040）。L-PTX组患者中性粒细胞减少发生率高于PTX组（χ²=4.079，P=0.043），白细胞减少发生率高于PTX组（χ²=4.422，P=0.035）和nab-PTX组（χ²=5.640，P=0.018）；nab-PTX组患者脱发、恶心呕吐、腹泻等不良反应发生率低于PTX组（χ²=5.530，P=0.019；χ²=6.423，P=0.011；χ²=4.438，P=0.035）和L-PTX组（χ²=5.025，P=0.025；χ²=5.025，P=0.025；χ²=5.088，P=0.024），周围神经炎发生率低于PTX组（χ²=4.711，P=0.030）。结论 Nab-PTX联合卡铂治疗头颈肿瘤的近期疗效显著，患者不良反应明显减少。

Abstract:

OBJECTIVE To investigate the efficacy of paclitaxel(PTX), PTX liposome(L-PTX) and albumin bound paclitaxel(nab-PTX) in head and neck tumors. METHODS A total of 69 patients with head and neck cancer who were admitted to our hospital from January 2017 to June 2018 were enrolled. Among them, 31 patients received PTX plus carboplatin as PTX group, 26 patients received L-PTX plus carboplatin as L-PTX group, 12 patients received nab-PTX combined with carboplatin as nab-PTX group. The short-term clinical efficacy and adverse reactions of the 3 groups were compared. RESULTS The response rate of the nab-PTX group was higher than that of the PTX group(66.67% vs 32.26%, χ²=4.209, P=0.040); the incidence of neutropenia in the L-PTX group was higher than in the PTX group(χ²=4.079, P=0.043), and the incidence of leukopenia was higher than in the PTX group(χ²=4.422, P=0.035) and the nab-PTX group(χ²=5.640, P=0.018); the incidence of adverse reactions such as alopecia, nausea and vomiting, diarrhea in the nab-PTX group was lower than that in the PTX group(χ²=5.530, P=0.019; χ²=6.423, P=0.011; χ²=4.438, P=0.035) and L-PTX group(χ²=5.025, P=0.025; χ²=5.025, P=0.025; χ²=5.088, P=0.024), the incidence of peripheral neuritis was lower than that of PTX group(χ²=4.711, P=0.030). CONCLUSION Nab-PTX combined with carboplatin is effective in the treatment of head and neck tumors, and the adverse reactions are milder.