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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 observe the short-term efficacy and toxicity of gemcitabine (GEM) combined with nedaplatin (NDP) in the treatment of advanced nasopharyngeal carcinoma. Methods Twenty-one patients were treated with first-line platinum regimen and second-line taxane regimen failed in patients with advanced nasopharyngeal carcinoma. GEM1000mg / m2 intravenous drip, the first 1,8d; NDP80mg / m2 intravenous drip, 1d, 3-4 weeks for a cycle, complete 2 cycles of chemotherapy to evaluate the efficacy and toxicity. Results There were no CR cases, 5 PR cases (23.8%), 9 SD cases (42.9%), 7 PD cases (33.3%), CR + PR 23.8% SD) 66.7%. The median response time was 4.2 months. The main toxicities were myelosuppression. The WBC and N in grade Ⅲ-Ⅳ decreased in 11 cases (52.4%) and in neutropenic fever (3 cases). The grade Ⅲ-Ⅳ platelet decreased in 12 cases (57.1%). Non-hematologic toxicity is mild. Conclusions The third-line administration of gemcitabine combined with nedaplatin solution is still a good effect on the treatment of nasopharyngeal carcinoma, with the exception of myelotoxicity other toxic side effects, after rigorous case selection and effective and timely prevention and treatment measures, as the third line of nasopharyngeal carcinoma chemotherapy Program clinical application of promotion.