吉西他滨联合阿帕替尼二线治疗复发转移性鼻咽癌疗效及安全性分析  

Efficacy and safety evaluation of gemcitabine combined with apatinib as second line treatment in patients with recurrent/metastatic nasopharyngeal carcinoma

作　　者：陈少卿[1] 黎军和[1] 余永春 胡明斌 刘运炜 严俊峰[2] CHEN Shao-qing;LI jun-he;YU Yong-chun;HU Ming-bin;LIU Yun-wei;YAN Jun-feng(First Affiliated Hospital of Nanchang University,Nanchang 330006,P.R.China)

机构地区：[1]南昌大学第一附属医院肿瘤科,江西南昌330006 [2]南昌大学第一附属医院口腔颌面外科,江西南昌330006

出　　处：《中华肿瘤防治杂志》2019年第20期1547-1550,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：江西省自然科学基金（20161BAB205241）

摘　　要：目的复发/转移性鼻咽癌的二线治疗目前尚无标准方案,其疗效也有待进一步提高,因此寻找新的方案用于二线治疗复发/转移性鼻咽癌成为当前的研究热点。本研究旨在评价吉西他滨联合阿帕替尼二线治疗复发/转移性鼻咽癌的疗效和安全性。方法收集2016-03-01-2017-01-31南昌大学第一附属医院肿瘤科采用吉西他滨联合阿帕替尼二线治疗复发/转移性鼻咽癌患者16例,方案具体为:吉西他滨1 000mg/m2,静脉滴入,d1、d8;联合阿帕替尼500mg,口服,1次/d,21d为1个周期,共6个周期,评估疗效并记录不良反应。结果纳入的16例晚期鼻咽癌患者中,15例完成6个周期治疗,1例完成4个周期治疗。完全缓解(complete response,CR)2例,部分缓解(partial response,PR)7例,疾病稳定(stable dis-ease,SD)6例,疾病进展(progressive disease,PD)1例。ORR=56.25%,95%CI为28.95~83.55,DCR=93.75%,95%CI为80.43~100.00,中位无疾病进展时间(median progression free survival,mPFS)为5.5个月(95%CI为4.4~6.6)。大部分不良反应≤Ⅱ级,出现Ⅲ级的不良反应包括白细胞减少、中性粒细胞减少、血红蛋白下降、血小板减少、恶心、呕吐、便秘、疲乏、肾功能损伤、高血压、蛋白尿及手足综合征。1例患者出现Ⅳ级血小板减少。结论吉西他滨联合阿帕替尼二线治疗复发/转移性鼻咽癌疗效确切,安全性良好。OBJECTIVE There is no standard second-line treatment for recurrent/metastatic nasopharyngeal carcinoma,and its efficacy needs to be further improved.Therefore,finding a new second-line treatment for recurrent/metastatic nasopharyngeal carcinoma has become a research hotspot.This study aimed to evaluate the efficacy and safety of gemcitabine combined with apatinib as second line treatment in patients with recurrent/metastatic nasopharyngeal carcinoma.METHODS From March 1,2016 to January 31,2017,16 cases of recurrent/metastatic nasopharyngeal carcinoma after failure of platinum-based chemotherapy were treated with gemcitabine combined with Apatinib in Oncology Department of First Affiliated Hospital of Nanchang University.The treatment scheme was:Gemcitabine 1 000 mg/m2,ivgtt,d1,d8+apatinib,500 mg,po,qd,21 days/cycle,with a total of 6 cycles.Evaluate the therapeutic effect and record the patient’s adverse reactions.RESULTS A total of 16 patients were enrolled.Of 16 patients,15 patients completed 6 cycles of chemotherapy and 1 completed 4 cycles of chemotherapy.Complete response was achieved in 2 patients,partial response in 7 patients,stable disease in 6 patients and progressive disease in 1 patient,with a objective response rate of 56.25%(95%CI:28.95-83.55)and a disease control rate was 93.75%(95%CI:80.43-100.00).The median progressive free survival was 5.5 months(95%CI:4.4-6.6).Most of the adverse reactions were less than gradeⅡ.The gradeⅢ adverse reactions include leukocytopenia,neutropenia,hemoglobin,thrombocytopenia,nausea,vomiting,constipation,fatigue,renal function injury,hypertension,proteinuria and hand foot syndrome.Grade Ⅳ thrombocytopenia constipation,fatigue,renal function injury,hypertension,proteinuria and hand foot syndrome.Grade Ⅳ thrombocytopenia was found in 1 patients.CONCLUSION Gemcitabine combined with apatinib as second line treatment is effective and safe in patients with recurrent/metastatic nasopharyngeal carcinoma.

关 键 词：鼻咽癌 吉西他滨 阿帕替尼 疗效 安全性 

分 类 号：R739.6[医药卫生—肿瘤]