GP方案与PF方案治疗初治后转移性鼻咽癌患者的对照性研究

目的:比较GP方案与PF方案治疗初治后转移性鼻咽癌患者的疗效。方法:收集2007年1月～2009年6月初治后转移性鼻咽癌患者54例。随机分为两组,A组28例给予PF方案(DDP25mg/m21～4天,5-FU0.75/m21～5天)化疗,PF方案化疗2周期有效者(CR+PR)则继续原方案化疗3～4个周期,PF方案化疗2周期未达PR者改用GP方案化疗;B组25例给予GP方案(Gemzar1000mg/m21～8天,DDP25mg/m21～4天)化疗,GP方案化疗2周期有效者(CR+PR)则继续原方案化疗3～4个周期,GP方案化疗2周期未达PR者改用其他方案化疗。化疗4周后评价化疗效果。结果:B组的RR为69.2%,明显高于A组(32.1%)。两组比较有统计学意义,P<0.05。A组中位进展时间4.7个月,中位生存时间7个月;B组中位进展时间6.5个月,中位生存时间14个月,显示B组较A组有较长的生存趋势。B组患者的Ⅱ、Ⅲ度血小板减少发生率明显高于A组(34.6%vs3.6%),两组比较有统计学意义,P<0.05。而在白细胞减少、血红蛋白减少、消化道毒副反应等方面两组比较无统计学差异。结论:吉西他滨联合顺铂治疗初次治疗后转移的鼻咽癌,疗效确切,毒副反应能耐受,比经典PF方案显示有更好的缓解率和生存受益,是初次治疗后转移性鼻咽癌患者的有效化疗方案。

Objective ：To observe the effect of the chemotherapy with DF orGP regimen for metastasis nasopharyngeal carcinoma. Methods：54 patients with metastatic nasopharyngeal carcinoma after first therapy failure from Feb,2007 to Jun,2009 were given into the trial. Group A ：28 patients were administered with DF regimen （DDP 25mg/m^2 D1 - 4,5 - FU 0.75/m^2 D1 - 5 ）. Patients who were effective （CR or PR）were continued with the treatment for 3 to 4 cycles. Patients who were not effective after 2 chemotherapy cycleswere administered with GP regimen. Group B：26 patients were administered with GP regimen （ Gemcitabine 1000mg/m^2 , D1 , 8, DDP 25mg/m^2 DI - 4）. Patients who were effective （ CRor PR） were continued with the treatment for 3 to 4 cycles. Patientswho were not effective afler 2 chemotherapy cycles were administered with other regimen. To evaluate the effect of the chemotherapy after two cycles ehemotherapies. Results： The response rate （ RR ） of B Group was higher than A Group （69. 2% vs32. 1% ）, The difference were significant （ P 〈0.05 ）. The Median time to progression of B Group and A group was 6.5 months,4. 7 months,respectively. The Median survival time B Group and A group was 14 months,7 months, respeetively. B Group was longer than A group in survival. The 2 - 3grade hromboeytopenia rate of B Group was higher than A group（ 34.6% vs3.6% ） , The difference of two groups was significant. But there were no difference betwween two groups with leukopenia, leukopenia, and digestive tract toxicity. Conclusion： Gemcitabine plus cisplatin （ GP regimen） was effective in treating metastatic nasophaqngeal carcinoma Patients after first threapy failure,and patients can tolerate the toxicity of GP regimen. GP regimen was more advantage than PF regimen in RR and survival. GP regimen is effective regimen in treating metastatic nasopharyngeal carcinoma Patients after first threapy failure.