吉西他滨联合卡铂治疗晚期鼻咽癌的临床观察

Combination of gemcitabine and carboplatin in the treatment of advanced nasopharyngeal carcinoma

目的观察吉西他滨联合卡铂方案治疗晚期复治鼻咽癌的疗效及毒性反应。方法34例均为一线含顺铂方案化疗失败的晚期鼻咽癌患者,给予吉西他滨与卡铂治疗,吉西他滨1000mg/m2,静脉滴注,第1、8天;卡铂AUC5,静脉滴注,第2天,21d为1周期,每例患者治疗2周期以上。结果全组完全缓解4例,部分缓解17例,稳定8例,进展5例,总有效率为61.8%。中位生存期8.3个月,1年生存率为43.8%。最常见的毒副反应为骨髓抑制,Ⅲ～Ⅳ度白细胞和血小板下降发生率分别为35.3%和23.6%,其余毒副反应均轻微,可耐受。结论吉西他滨联合卡铂方案对一线含顺铂方案化疗失败的晚期鼻咽癌有较好的疗效,毒性反应可以耐受。

Objective To evaluate the efficacy and toxicity of the combination of gemcitabine and carboplatin as second-line treatment of patients with advanced nasopharyngeal carcinoma（NPC）.Methods Thirty-four patients with advanced NPC failed to previous cisplatin-based chemotherapy were enrolled into the study.The patients received gemcitabine 1000mg/m^2on days l,8 and carboplatin AUC 5 on day 2,with 21 days as a cycle.Each patient received at least two cycles.Results Of the 34 patients,4 cases got complete response,17 got partial response,8 had stable disease,and 5 had progressive disease,with an overall response rate of 61.8%.The median survival duration was 8.3 months.The 1-year survival rate was 43.8%.The main toxic reactions were leukopenia（incidence of 35.3% for grade Ⅲ ＋ Ⅳ） and thrombocytopenia（incidence of 23.6% for grade Ⅲ ＋ Ⅳ）.Conclusion The combination of gemcitabine and carboplatin is a feasible,well-tolerated and active scheme in second-line treatment of advanced NPC