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目的 探讨吉西他滨+顺铂(GP)方案与紫杉醇+顺铂(TP)方案治疗复发或转移性鼻咽癌的临床效果.方法 选取2012年9月至2017年12月在河北省秦皇岛市海港医院治疗的130例复发或转移性鼻咽癌患者,根据选取的治疗方案分为GP组(68例)和TP组(62例),GP组给予GP方案治疗,TP组给予TP方案治疗,观察两组临床疗效及不良反应,检测化疗前后血清上皮型钙黏蛋白(SE-CAD)和血小板源性生长因子(PDGF-BB)水平.结果 GP组和TP组近期疗效比较差异无统计学意义(P＞0.05),总有效率分别为88.24％ (60/68)和79.03％(49/62);GP组和TP组治疗后1个月SE-CAD分别为(2.57±0.81) g/L和(2.50±0.96) g/L,PDGF-BB分别为(102.22±31.18)ng/L和(110.15±37.21) ng/L,两组比较差异无统计学意义(P＞0.05);GP组和TP组无进展生存时间(PFS)分别为13个月和12个月,总生存时间(OS)分别为17个月和16个月,两组比较差异无统计学意义(P＞0.05);GP组和TP组白细胞减少、血红蛋白减少、血小板减少和肝肾功能异常发生率比较差异无统计学意义(P＞0.05);GP组胃肠道反应发生率为16.18％(11/68),明显低于TP组的38.71％(24/62),差异有统计学意义(P＜0.01).结论 GP与TP方案治疗复发或转移性鼻咽癌有较好的效果,两种方案治疗后SE-CAD、PDGF-BB水平无显著差异,但GP方案的胃肠道反应发生率较低.“,”Objective To evaluate the clinical efficacy of gemcitabine plus cisplatin (GP) regimen and paclitaxel plus cisplatin (TP) regimen in the treatment of recurrent or metastatic nasopharyngeal carcinoma.Methods One hundred and thirty patients with recurrent or metastatic nasopharyngeal carcinoma of Qinhuangdao Harbor Hospital,Hebei Province between September 2012 and December 2017 were chosen,and were divided into GP group (68 cases) and TP group (62 cases)according to the selection of treatment.GP group was treated with GP regimen,and TP group was treated with TP regimen.The clinical efficacy and adverse reactions of the two groups were observed,and the serum epithelial cadherin (SE-CAD) and platelet-derived growth factor (PDGF-BB) were measured before and after chemotherapy.Results There was no significant difference in short-term efficacy between GP group and TP group (P＞0.05),and the total effective rates were 88.24％ (60/68) and 79.03％ (49/62) respectively;1 month after treatment,SE-CAD in GP group and TP group were (2.57 ± 0.81) and (2.50 ± 0.96) g/L,PDGF-BB were (102.22 ± 31.18) and (110.15 ± 37.21) ng/L,and the difference was not statistically significant (P＞0.05);progression-free survival (PFS) in GP group and TP group were 13 and 12 months,and overall survival (OS) were 17 and 16 months,and the difference was not statistically significant (P＞0.05);there were no significant difference in leucopenia,hemoglobin,thrombocytopenia and abnormal liver and kidney function between GP group and TP group (P＞0.05);the incidence of gastrointestinal reactions in GP group was 16.18％ (11/68),which was significantly lower than that in TP group was 38.71％(24/62),and the difference was statistically significant (P＜0.01).Conclusions GP and TP regimens are effective in the treatment of recurrent or metastatic nasopharyngeal carcinoma.There is no significant difference in SE-CAD and PDGF-BB levels between the two regimens after treatment,but GP regimen has a lower incidence of gastrointestinal reactions.