吉西他滨联合长春瑞滨二线治疗转移性鼻咽癌的临床疗效

目的 观察吉西他滨联合长春瑞滨(GV)二线治疗含铂类药物方案化疗失败转移性鼻咽癌(nasopharyngeal carcinoma,NPC)患者的疗效,并分析影响预后的因素。方法 回顾性分析2010年1月至2016年3月于广西医科大学附属肿瘤医院经含铂类药物方案一线化疗失败后予GV方案治疗的41例转移性NPC患者的临床病理资料,采用Cox比例风险回归分析影响其预后的因素。结果 41例转移性NPC患者共完成146个周期化疗,中位周期数为4个周期,总有效率为42.9%,疾病控制率为85.8%。中位无进展生存期为6.0个月(95%CI:4.4~7.6),中位生存期为16.4个月(95%CI:8.8~24.0)。骨髓抑制是主要的不良反应,患者可耐受。多因素分析结果显示,二线化疗周期数是影响患者预后的独立因素(HR=2.660, 95%CI:1.044~6.781,P=0.040)。结论 GV方案二线治疗含铂类药物方案一线化疗失败的转移性NPC患者安全有效,且化疗周期数≥4的患者预后可能更佳。

Clinical observations of gemcitabine combined with vinorelbine as second-line treatment in patients with metastatic nasopharyngeal carcinoma

Objective To investigate the efficacy and safety of gemcitabine combined with vinorelbine(GV) in the second-line treatment of patients with metastatic nasopharyngeal carcinoma(NPC). Methods Clinical data were retrospectively analyzed for 41 patients with metastatic NPC who received second-line therapy at Affiliated Tumor Hospital of Guangxi Medical University  from January 2010 to March 2016. The prognostic factors were analyzed by multivariate Cox regression. Results A total of 41 patients with metastasis NPC completed 146 cycles of GV chemotherapy,the median number of cycles was 4 cycles, and the total efficacy rate was 42.9%, the disease control rate was 85.8%. The median progression free survival was 6.0 months(95%CI:4.4-7.6), and median overall survival was 16.4 months (95%CI: 8.8-24.0). Myelosuppression was the major adverse reaction and could be tolerated. Multivariate analysis showed that the cycles of GV chemotherapy was an independent prognostic factor(HR=2.660,95%CI:1.044-6.781,P=0.040). Conclusions Gemcitabine combined with vinorelbine is an effective ragmen for treating patients with  metastatic nasopharyngeal carcinoma,especially for those who have failed to platinum-based chemotherapy, and patients with more than 4 cycles of GV chemotherapy indicates better prognosis.