吉西他滨联合奥沙利铂治疗复发性鼻咽癌的疗效

Curative effect of gemcitabine combined with oxaliplatin in the treatment of recurrent nasopharyngeal carcinoma

目的探讨吉西他滨联合奥沙利铂（GEMOX方案）治疗晚期鼻咽癌的临床疗效和安全性。方法选取2011年1月至2014年12月间佛山市第一人民医院采用GEMOX方案治疗晚期顺铂、氟尿嘧啶（5-Fu）耐药的鼻咽癌患者52例,吉西他滨1 000 mg/m2静滴,第1、8天;奥沙利铂65 mg/m2静滴,第1、8天,21 d为1个周期,每2个周期评价疗效1次。结果 52例患者共完成120个周期化疗,每例患者完成2~6个周期,平均3.7个周期,其中部分缓解10例（19.2%）,稳定24例（46.2%）,进展18例（34.6%）;总有效率19.2%,疾病控制率65.4%;无进展生存期（PFS）2~24个月中位PFS为6.5个月;主要毒副反应为白细胞减少、血小板减少、恶心呕吐和肝功能损害,均以1~2度为主,患者耐受性好。结论 GEMOX方案治疗顺铂、5-Fu耐药的晚期鼻咽癌疗效好,不良反应可耐受,值得临床推广。

Objective To explore the curative effect of gemcitabine combined with oxaliplatin（ GEMOX） in the treatment of recurrent nasopharyngeal carcinoma. Methods From January 2011 to December 2014 in The First People＇s Hospital of Foshan,52 nasopharyngeal carcinoma（ NPC） resistant to cisplatin and 5-Fluorouracil（ 5-FU） were enrolled in the study. They accept GEMOX： gemcitabine 1 000 mg /m2,ivdrip,d1,d8. 65 mg/m2 oxaliplatin,iv,drip,d1,d8,21 d is a cycle. The curative effect was compared. Results 52 patients completed 120 cycles of chemotherapy,an average of 3. 7 cycles（ 2 ~ 6 cycles）. 10 cases（ 19. 2%） achieved complete response,24 cases（ 46. 2%） stable disease and 18 cases（ 34. 6%） progressive disease. The total effective rate was 19. 2% and the disease control rate was 65. 4%.The progression free survival（ PFS） was 6. 5 ~ 24 mo ths（ 2 mo ths）. The main side reactions were leukopenia,thrombocytopenia,nausea and vomiting and liver function damage,mostly 1 ~ 2 degrees,with good tolerance. Conclusions GEMOX regimen for cisplatin,5-Fu resistant advanced nasopharyngeal carcinoma could reach good curative effect and the adverse reaction can be tolerated. It is worthy of clinical application.