低剂量吉西他滨延时输注联合奈达铂治疗转移性鼻咽癌的临床观察  

Clinical observation prolonged infusion of low-dose gemcitabine combined with nedaplatin in treatment of recurrent /metastatic nasopharyngeal carcinoma

作　　者：管慧红[1] 杨宏凯[1] 周岚[1] 徐建芳[1] 陈焰[1] 

机构地区：[1]汕头市中心医院肿瘤内科,汕头515031

出　　处：《新医学》2014年第8期555-557,共3页Journal of New Medicine

摘　　要：目的：评价低剂量吉西他滨延时输注联合奈达铂治疗转移性鼻咽癌的疗效及耐受性。方法选择26例复发或转移性鼻咽癌患者，治疗第1、8日，予吉西他滨250 mg/m2，持续输注6 h；治疗第1日予奈达铂80 mg/m2，持续输注2 h；每28 d重复1次。观察治疗反应率（ORR）、无进展生存期（PFS）、1年生存率及其毒副作用。结果26例患者的ORR为81％。中位随访时间13（95％CI 10～19）个月，中位PFS为7个月（95％CI 5.0～11）个月，1年生存率为58％。血液学毒性反应耐受良好，Ⅰ～Ⅱ级白细胞、血小板减少的发生率分别为54％和39％，未观察到Ⅲ～Ⅳ级白细胞减少及血小板减少。非血液学毒性轻微，胃肠道反应发生率为23％，口咽黏膜炎发生率为70％，脱发发生率为46％。结论低剂量延时输注吉西他滨联合奈达铂治疗转移性鼻咽癌疗效可，毒副作用相对较轻。Objective To evaluate the efficacy and tolerability of prolonged infusion of low-dose gemcitabine combined with nedaplatin in treatment of recurrent/metastatic nasopharyngeal carcinoma. Methods Twenty-six patients with recurrent/metastatic nasopharyngeal carcinoma received gemcitabine at a dose of 250 mg/m2 civ for 6h on days 1 and 8 ; nedaplatin at a dose of 80 mg/m2 was administered on day 1 every 28 days. The overall response rate （ORR）, progression-free survival （PFS） and 1-year survival rate and side effects were evaluated. Results Among 26 patients, ORR was 80. 7%. The median follow-up time was 13 months （95% CI, range： 10 - 19）. The median PFS was 7.0 months （95% CI, range： 5-10. 5）. The 1-year survival rate was 57. 7%. Hematologic toxicities were well tolerated and the occurrence of grade I - II leukocytopenia and thrombocytopenia were 53.8% and 38.5%. Grade Ⅲ - Ⅳ leukocytopenia and thrombocytopenia were not observed. Mild non-hematologic toxicities were observed with 23. 1% of gastrointestinal response, 70% of oropharyngeal mucositis and 46% of alopecia. Conclusion Prolonged infusion of low-dose gemcitabine in combination with nedaplatin was efficacious in treatment of metastatic nasopharyngeal carcinoma and yielded relatively mild side effects.

关 键 词：低剂量吉西他滨 6h持续输注 奈达铂 鼻咽癌 

分 类 号：R734.2[医药卫生—肿瘤]