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目的:评价吉西他滨+顺铂联合放疗序贯治疗中晚期鼻咽癌患者的疗效及其毒副反应,探讨中晚期鼻咽癌新的综合治疗方案。方法:采用常规放疗联合GP化疗方案序贯治疗中晚期(Ⅲ和ⅣA)鼻咽癌患者80例,吉西他滨800mg/m2,静脉滴入,d1、d8;DDP15mg/m2,静脉滴入,d1～d5,每4周重复,共4个周期,并行常规放疗。评价其近远期疗效及毒副反应。结果:经治疗后80例患者鼻咽及颈部病灶均完全消失,病例随访≥3年。毒副反应主要表现骨髓抑制及胃肠道反应,尤其以血小板下降为明显。1、2和3年生存病例分别为80、78和78例;1例1年内复发,1例1年内发生骨转移并于首诊后16个月死亡,1例1～2年内发现复发转移并死亡;其余77例未发现复发转移。结论:吉西他滨+顺铂化疗联合放疗治疗中晚期鼻咽癌疗效显著,值得临床应用。
Objective: To evaluate the efficacy and side effects of gemcitabine combined with cisplatin and sequential radiotherapy in the treatment of advanced nasopharyngeal carcinoma (NPC), and to explore a new comprehensive treatment regimen for advanced nasopharyngeal carcinoma. Methods: Eighty patients with advanced nasopharyngeal carcinoma (Ⅲ and ⅣA) were treated with routine radiotherapy and GP chemotherapy. Gemcitabine 800 mg / m 2, intravenous drip, d 1 and d 8, DDP 15 mg / m 2, intravenous drip, d 1 d 5 , Repeated every 4 weeks, a total of 4 cycles, conventional radiotherapy. Evaluation of its short-term efficacy and toxicity. Results: After treatment, 80 cases of nasopharyngeal and neck lesions were completely disappeared, the case was followed up ≥ 3 years. Toxicity mainly manifested myelosuppression and gastrointestinal reactions, especially for the obvious decrease of platelets. One, two and three year survival cases were 80, 78 and 78 cases respectively. One case had recurrence within one year, one case had bone metastasis within one year and died within 16 months after the first diagnosis. One case had recurrence and metastasis within one to two years Death; the remaining 77 cases found no recurrence and metastasis. Conclusion: Gemcitabine + cisplatin combined with radiotherapy in the treatment of advanced nasopharyngeal carcinoma has a significant effect, which is worthy of clinical application.