GEMOX方案新辅助化疗治疗局部晚期鼻咽癌的临床观察

目的 探讨吉西他滨联合奥沙利铂（GEMOX）方案新辅助化疗治疗局部晚期鼻咽癌的疗效和安全性.方法 收集本科室共39例接受GEMOX方案新辅助化疗治疗的局部晚期鼻咽癌患者的临床资料,具体用药为：吉西他滨1 000 mg/m2静滴,第一天,第八天;奥沙利铂100 mg/m2静滴,第一天,21天为一周期,2个周期后评价疗效.结果 39例患者共完成78个周期化疗,每例均接受2个周期.39例患者均可评价疗效和毒副反应,获完全缓解（CR）3例（7.7%）,部分缓解（PR）30例（76.9%）,稳定（SD）5例（12.8%）,进展（PD）1例（2.6%）,总有效率（RR）为84.6%,疾病控制率（DCR）为97.4%.主要毒副反应为白细胞减少、血小板减少、皮疹、恶心呕吐和肝功能损害,均以1～2级为主.结论 GEMOX方案新辅助化疗治疗局部晚期鼻咽癌疗效好,毒副反应可耐受,值得临床进一步应用.

Clinical Observation on Gemcitabine Combined with Oxaliplatin asthe Neoadjuvant Chemotherapy in Treatment of Locally Advanced Nasopharyngeal Carcinoma

Objective To observe the efficacy and satefy of gemcitabine combined with oxaliplatation in treatment of locoregionally advanced nasopharyngeal carcinoma. Methods From June 2008 to February 2013,39 patients with locore- gionally advanced nasopharyngeal carcinoma were treated with GEMOX regimen as the neoadjuvant chemotherapy. GEMOX regimen was taken as followed：gemcitabin 1000mg/m2 iv dl ,d8 ;oxaliplatation 100mg/m2 iv dl. Twenty-one days was a cy- cle. The efficacy was evaluated after 2 cycles. Results 39 patients received 78 cycles in total with 2 cycies every one. The efficacy and side effects could be evaluated in all. In the 39 patients, 3 （7.7%）got CR,30 （76.9%）PR,5 （ 12. 8 % ）SD and 1 （2.6%） PD. The overall response rate（RR） was 84.6% and disease control rate was 97.4%. The main side effects were leukopenia, thrombocytopenia, rash, vomiting/nausea and liver function impairment. They were mainly in grade 1 - 2. Conclusion GEMOX regimen is effective and tolerable as the neoadjuvant chemotherapy in treatment of locoregionally ad- vanced nasopharyngeal carcinoma, and is worth of further clincal application.