吉西他滨联合奈达铂三线治疗晚期鼻咽癌的临床观察  

Gemcitabine plus Nedaplatin as third-line chemotherapy in patients with metastatic Nasopharyngeal Carcinoma

作　　者：覃慕萍[1] 谢杰雄[1] 李伟卓[1] 崔娟[1] 

机构地区：[1]广西梧州市红十字会医院化疗一科,543002

出　　处：《中国医疗前沿》2013年第3期10-11,共2页China Healthcare Innovation

摘　　要：目的观察吉西他滨(gemcitabine,GEM)联合奈达铂(nedaplatin,NDP)的方案治疗晚期鼻咽癌的近期疗效及毒性反应。方法 21例均为一线含铂方案及二线紫杉类方案化疗失败的晚期鼻咽癌患者。GEM1000mg/m2静脉滴注,第1、8d;NDP80mg/m2静脉滴注,第1d,3-4周为1个周期,完成2周期化疗后评价疗效及毒性反应。结果 21例患者无CR病例,5例PR(23.8%),9例SD(42.9%),7例PD(33.3%),有效率(CR+PR)23.8%,疾病控制率(CR+PR+SD)66.7%。中位缓解时间4.2个月。主要毒副反应为骨髓抑制:Ⅲ-Ⅳ度的WBC及N下降11例,占52.4%,粒细胞减少性发热有3例;Ⅲ-Ⅳ度的血小板下降12例,占57.1%。非血液学毒性轻微。结论吉西他滨联合奈达铂方案三线用药对鼻咽癌仍有较好疗效,除骨髓毒性外其他毒副反应轻微,经过严格的病例选择及采取有效及时的防治措施,可作为鼻咽癌化疗的三线方案临床应用推广。Objective To evaluate the short term efficacy and toxicity of gemcitabine in combination with nedaplatin as third-line treatment in the patients with metastatic nasopharyngeal carcinoma（NPC）. Methods All patients had been previously treated for recurrent disease with a first-line cisplatin-based chemotherapy and a second-line therapy with paclitaxel or docetaxel. Gemcitabine was given on day 1, 8 at a dose of 1000mg/m2 and nedaplatin on days 1 at a dose of 80mg/m2. The chemotherapy was repeated every 3 or 4 weeks. Efficacy and toxicity would be evaluated after the completion of two cycles of chemotherapy. Results No complete response occurred in the patients. Partial remission was observed in 5 patients（23.8%）, 9 patients achieved a stable status（42.9%）, 7 patients suffered from progressive disease（33.3%）. The total response rate（CR＋PR） was 23.8% and the disease control rate（CR＋PR＋SD） was 56.7%. Median time to progression（TTP） was 4.2 months. Hematological toxicities were the predominant side effects with grade 3/4 leukopenia, thrombocytopenia were observed in 52.4%, 57.1% of patients ,respectively, 3 febrile neutropenia occurred. Non-hematological toxicity was mild. Conclusion The combination of gemcitabine and nedaplatin showed a promising results as third-line chemotherapy in patients with metastatic NPC, which merits the further study in a prospective clinical trial.

关 键 词：鼻咽癌 吉西他滨 奈达铂 化疗 

分 类 号：R739.6[医药卫生—肿瘤]