吉西他滨固定速率输注二线治疗晚期铂类耐药鼻咽癌疗效观察

Effect of Gemcitabine Fixed-rate Infusion Second-line Treatment in Advanced Platinum-resistant Nasopharyngeal Carcinoma

目的:探讨吉西他滨固定速率输注二线治疗晚期铂类耐药鼻咽癌的临床疗效。方法:选取2016年1月-2018年3月在本院就诊的晚期铂类耐药鼻咽癌患者30例。行单药吉西他滨固定速率静脉输注2 h化疗,采用WHO化疗毒副反应分级标准进行化疗毒副反应的评估,分为0～Ⅳ级;记录患者的疾病进展时间(time to progression,TTP)、治疗失败时间(time to failure,TTF);采用欧洲癌症患者生活质量调查问卷(QLQ-C30)对患者治疗前后的生活质量进行调查,对患者的治疗效果进行评价。结果:30例患者中,0例完全缓解,15例(50.00%)部分缓解,5例(16.67%)疾病稳定,10例(33.33%)疾病进展,疾病控制率为66.7%,中位TTP为5.42个月,中位TTF为6.94个月。鼻咽癌患者恶心呕吐、贫血、血小板减少Ⅲ级发生率均为3.33%,肝功能损害较为少见,无Ⅳ级毒副反应患者;治疗后鼻咽癌患者生活质量各项评分均显著高于治疗前,差异均有统计学意义(P<0.05)。结论:单药吉西他滨固定速率输注二线治疗晚期铂类耐药鼻咽癌,具有较好的疾病控制率,提高患者的生活质量,且患者机体毒副反应较小,具有较好的耐受性,值得临床推广。

Objective:To investigate the clinical efficacy of Gemcitabine in the second-line treatment of advanced platinum-resistant nasopharyngeal carcinoma.Method:30 patients with platinumresistant nasopharyngeal carcinoma in our hospital from January 2016 to March 2018 were selected.All patients were given single-agent intravenous infusion of gemcitabine fixed rate intravenous infusion for 2 h.The chemotherapy toxicity was evaluated by WHO chemotherapy toxicity side effects criteria,divided into grade 0 to grade IV.The time to progression(TTP)and time to failure(TTF)were record.The quality of life before and after treatment and the patient’s treatment effect were evaluated by European Quality of Life Questionnaire for Cancer Patients(QLQ-C30).Result:Of the 30 patients,no complete remission,15 cases(50.00%)had partial remission,5 cases(16.67%)had stable disease and 10 cases(33.33%)had disease progression.The disease control rate was 66.7%.The median TTP was 5.42 months and the median TTF was 6.94 months.The incidence of nausea and vomiting,anemia and thrombocytopenia in patients with nasopharyngeal carcinoma was 3.33%.The liver function impairment was rare,and there was no grade IV toxic reaction.The quality of life of patients with nasopharyngeal carcinoma after treatment was significantly higher than that before treatment.The difference was statistically significant(P<0.05).Conclusion:The singleagent gemcitabine fixed-rate infusion second-line treatment of advanced platinum-resistant nasopharyngeal carcinoma,has a better rate of disease control,improve the patient’s quality of life,the patient’s body toxicity is relatively small,has a good tolerance,worthy of cli nical promotion.