摘要
目的晚期鼻咽癌的一线治疗是以含铂类为主的联合方案,对于铂类耐药后的患者目前尚无标准治疗方案。本研究评价吉西他滨联合替吉奥治疗铂类方案化疗失败后晚期鼻咽癌患者的疗效和安全性。方法回顾性分析2014-01-01-2017-06-30中南大学湘雅医学院附属海口医院收治的含铂类方案化疗失败后晚期鼻咽癌患者66例,根据治疗方法不同分为联合组(32例)和单药组(34例)。联合组:吉西他滨1 000mg/m2,持续静脉滴入30min,d1、d8;替吉奥80mg/(m2d),口服,分2次,d1～d14。单药组:吉西他滨1 000mg/m2,持续静脉滴入30min,d1、d8。两种治疗方案均21d为1个周期。分析两组患者的疗效和不良反应并进行随访。结果联合组与单药组的客观有效率分别为40.6%和17.6%,χ~2=3.898,P=0.048;疾病控制率分别为75.0%和67.6%,χ~2=0.435,P=0.510。中位无进展生存时间分别为6.0和5.0个月,χ~2=2.826,P=0.093;中位总生存时间分别为15.2和13.0个月,χ~2=1.131,P=0.288;1年生存率为分别64.8%和52.9%。两组最常见的不良反应为骨髓抑制及消化道反应,两组出现Ⅲ～Ⅳ级的骨髓抑制及消化道反应之间的差异无统计学意义,P>0.05。结论吉西他滨联合替吉奥治疗对铂类方案化疗失败后的晚期鼻咽癌的临床效果较好,较单药化疗组生存期延长,且患者耐受性较好,可以作为一种治疗选择。
OBJECTIVE Nasopharyngeal carcinoma( NPC) is prevalent in South China.Palliative chemotherapy has been used mostly with platinum-based regimens as a first line treatment.No standard salvage regimen has been used for patients with advanced nasopharyngeal carcinoma and disease progression after prior platinumbased chemotherapy.This study aimed to investigate the efficacy and safety of gemcitabine combined with tegafur in patients with advanced nasopharyngeal carcinoma previously treated with platinums.METHODS From January 1,2014 to June 30,2017,66 cases of advanced nasopharyngeal carcinoma of prior platinum based chemotherapy failure were retrospectively selected in Affiliated Haikou Hospital.The 66 patients were separated into 2 groups, 32 patients received gemcitabine combined with tegafur chemotherapy regimen(combined group),gemcitabine 1 000 mg/m^2 given intravenously over 30 minutes on days 1 and 8 with tegafur 80 mg/(m^2·d) given orally twice a day from days 1 to 14 of a 21 days cycle.The other 34 patients received gemcitabine only 1 000 mg/m^2 on days 1 and 8 (single group) of a 21 days cycle.The adverse reactions and efficacy were evaluated aftert reatment.The patients were followed-up,and the survival was analyzed.RESULTS The objective response rates of combined group and single group were respectively 40.6 % and 17.6%(X^2=3.898,P=0.048).The disease control rate was 75.0% and 67.6%(X^2=0.435,P=0.510).The median progression-free survival was 6.0 months and 5.0months(X^2=2.826,P=0.093),and the median overall survival was 15.2 months and 13.0 months(X^2=1.131,P=0.288).The 1-year survival rate was 64.8% and 52.9%.The most frequent adverse reactions of the both groups was myelosuppression and gastrointestinal reactions,the grade Ⅲ-Ⅳ myelosuppression and gastrointestinal reactions occurred in the two groups*but they had no statistical significanee.CONCLUSIONS Compared with gemcitabine group, the survival period of gemcitabine combined with tegafur, gimeracil and oteracil porassium capsules group was Ion ger and well tolerated in the treatment of advanced nasopharyngeal carcinoma after failure of platinum based chemotherapy.It can be used as a treatment option.
作者
元建华
李建旺
张曙波
毛山山
王美清
崔荣花
YUAN Jian-hua;LI Jian-wang;ZHANG Shu-bo;MAO Shan-shan;WANG Mei-qing;CUI Rong hua(Department of Oncology,Affiliated Haikou Hospital of Xiangya Medical College Central South University,Haikou 570208,P.R.China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2019年第3期170-174,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
鼻咽癌
吉西他滨
替吉奥
化疗
铂类耐药
nasopharyngeal carcinoma
gemcitabine
tegafur
chemotherapy,platinum-resistant
