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目的探讨吉西他滨联合奥沙利铂(GEMOX方案)治疗晚期鼻咽癌的临床疗效和安全性。方法选取2011年1月至2014年12月间佛山市第一人民医院采用GEMOX方案治疗晚期顺铂、氟尿嘧啶(5-Fu)耐药的鼻咽癌患者52例,吉西他滨1 000 mg/m2静滴,第1、8天;奥沙利铂65 mg/m2静滴,第1、8天,21 d为1个周期,每2个周期评价疗效1次。结果 52例患者共完成120个周期化疗,每例患者完成2~6个周期,平均3.7个周期,其中部分缓解10例(19.2%),稳定24例(46.2%),进展18例(34.6%);总有效率19.2%,疾病控制率65.4%;无进展生存期(PFS)2~24个月中位PFS为6.5个月;主要毒副反应为白细胞减少、血小板减少、恶心呕吐和肝功能损害,均以1~2度为主,患者耐受性好。结论 GEMOX方案治疗顺铂、5-Fu耐药的晚期鼻咽癌疗效好,不良反应可耐受,值得临床推广。
Objective To investigate the clinical efficacy and safety of gemcitabine combined with oxaliplatin (GEMOX) in the treatment of advanced nasopharyngeal carcinoma. Methods From January 2011 to December 2014, 52 cases of nasopharyngeal carcinoma patients with advanced cisplatin and 5-fluorouracil were treated with GEMOX regimen in the First People’s Hospital of Foshan City from January 2011 to December 2014. Gemcitabine 1 000 mg / , Day 1, day 8; Oxaliplatin 65 mg / m2 intravenous infusion, on day 1, day 8 and day 21 for 1 cycle, every 2 cycles to evaluate the efficacy of 1 time. Results A total of 52 patients completed 120 cycles of chemotherapy. Each patient completed 2 to 6 cycles with an average of 3.7 cycles, of which 10 were partially relieved (19.2%), 24 (46.2%) were stabilized, and 18 (34.6% ). The total effective rate was 19.2% and the disease control rate was 65.4%. The median progression-free survival (PFS) median PFS was 6.5 months between 2 and 24 months. The main toxicities were leukopenia, thrombocytopenia, nausea and vomiting and liver function Damage, are mainly 1 to 2 degrees, patients are well tolerated. Conclusion GEMOX regimen is effective in treating advanced nasopharyngeal carcinoma with cisplatin and 5-Fu resistance, and its adverse reactions are tolerable. It is worthy of clinical promotion.