中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2015年
8期
632-636
,共5页
胡少轩%何小慧%董梅%郏博%周生余%杨建良%杨晟%张长弓%刘鹏%秦燕%桂琳
鬍少軒%何小慧%董梅%郟博%週生餘%楊建良%楊晟%張長弓%劉鵬%秦燕%桂琳
호소헌%하소혜%동매%겹박%주생여%양건량%양성%장장궁%류붕%진연%계림
鼻咽肿瘤%药物疗法%吉西他滨%异环磷酰胺%治疗效果%预后
鼻嚥腫瘤%藥物療法%吉西他濱%異環燐酰胺%治療效果%預後
비인종류%약물요법%길서타빈%이배린선알%치료효과%예후
Nasopharyngeal neoplasms%Drug therapy%Gemcitabine%Ifosfamide%Treatment outcome%Prognosis
目的:评价吉西他滨联合异环磷酰胺( GI)方案治疗铂类方案化疗失败后复发或转移性鼻咽癌患者的疗效和安全性。方法回顾性分析2005年4月至2014年3月间接受GI方案治疗的27例铂类方案化疗失败后复发或转移性鼻咽癌患者的临床病理资料及其预后相关的影响因素。结果27例患者均可评价疗效和毒副反应。其中部分缓解(PR)10例(37.0%),稳定(SD)13例(48.1%),进展(PD)4例(14.8%),有效率为37.0%,疾病控制率为85.2%。27例患者的中位无进展生存时间(PFS)为6.7个月,其中10例PR患者的中位PFS为10.6个月,中位缓解时间为5.5个月。27例患者的中位总生存时间(OS)为17.4个月,1年生存率为72.6%。毒副反应主要为血液学毒性,其中Ⅲ~Ⅳ度中性粒细胞减少发生率为37.0%,Ⅲ~Ⅳ度血小板减少发生率为18.5%,Ⅲ~Ⅳ度血红蛋白降低发生率为3.7%。多因素分析显示,吉西他滨剂量强度是影响患者PFS的主要因素,是否接受后续治疗是影响患者OS的主要因素(均P<0.05)。结论 GI方案治疗铂类方案化疗失败后的晚期鼻咽癌患者疗效确切,患者耐受性好,值得进一步临床研究。
目的:評價吉西他濱聯閤異環燐酰胺( GI)方案治療鉑類方案化療失敗後複髮或轉移性鼻嚥癌患者的療效和安全性。方法迴顧性分析2005年4月至2014年3月間接受GI方案治療的27例鉑類方案化療失敗後複髮或轉移性鼻嚥癌患者的臨床病理資料及其預後相關的影響因素。結果27例患者均可評價療效和毒副反應。其中部分緩解(PR)10例(37.0%),穩定(SD)13例(48.1%),進展(PD)4例(14.8%),有效率為37.0%,疾病控製率為85.2%。27例患者的中位無進展生存時間(PFS)為6.7箇月,其中10例PR患者的中位PFS為10.6箇月,中位緩解時間為5.5箇月。27例患者的中位總生存時間(OS)為17.4箇月,1年生存率為72.6%。毒副反應主要為血液學毒性,其中Ⅲ~Ⅳ度中性粒細胞減少髮生率為37.0%,Ⅲ~Ⅳ度血小闆減少髮生率為18.5%,Ⅲ~Ⅳ度血紅蛋白降低髮生率為3.7%。多因素分析顯示,吉西他濱劑量彊度是影響患者PFS的主要因素,是否接受後續治療是影響患者OS的主要因素(均P<0.05)。結論 GI方案治療鉑類方案化療失敗後的晚期鼻嚥癌患者療效確切,患者耐受性好,值得進一步臨床研究。
목적:평개길서타빈연합이배린선알( GI)방안치료박류방안화료실패후복발혹전이성비인암환자적료효화안전성。방법회고성분석2005년4월지2014년3월간접수GI방안치료적27례박류방안화료실패후복발혹전이성비인암환자적림상병리자료급기예후상관적영향인소。결과27례환자균가평개료효화독부반응。기중부분완해(PR)10례(37.0%),은정(SD)13례(48.1%),진전(PD)4례(14.8%),유효솔위37.0%,질병공제솔위85.2%。27례환자적중위무진전생존시간(PFS)위6.7개월,기중10례PR환자적중위PFS위10.6개월,중위완해시간위5.5개월。27례환자적중위총생존시간(OS)위17.4개월,1년생존솔위72.6%。독부반응주요위혈액학독성,기중Ⅲ~Ⅳ도중성립세포감소발생솔위37.0%,Ⅲ~Ⅳ도혈소판감소발생솔위18.5%,Ⅲ~Ⅳ도혈홍단백강저발생솔위3.7%。다인소분석현시,길서타빈제량강도시영향환자PFS적주요인소,시부접수후속치료시영향환자OS적주요인소(균P<0.05)。결론 GI방안치료박류방안화료실패후적만기비인암환자료효학절,환자내수성호,치득진일보림상연구。
Objective To evaluate the efficacy and safety of gemcitabine combined with ifosfamide (GI regimen) in patients with recurrent or metastatic nasopharyngeal carcinoma after failure of platinum?based chemotherapy. Methods The clinical data of 27 nasopharyngeal carcinoma patients, who received GI regimen between April 2005 and March 2014 after failure of prior platinum?based chemotherapy, were retrospectively reviewed,and relevant prognostic factors were explored. Results All patients were evaluable for efficacy and toxicity. No patient achieved complete response ( CR) . Partial response ( PR) was achieved in ten patients, stable disease ( SD) in thirteen patients, progressive disease ( PD) in four patients, with a response rate of 37.0% and an overall disease control rate (PR+SD) of 85.2%. For ten PR patients, the median duration of response was 5.5 months. The median progression?free survival of the whole group was 6.7 months, and the Kaplan?Meier estimate of median overall survival was 17.4 months. The 1?year survival rate was 72.6%. Toxicity was mainly hematological: Grade Ⅲ or Ⅳ anemia, neutropenia and thrombocytopenia were found in 3.7%, 37.0% and 18.5% of all patients, respectively. Univariate and multivariate analyses indicated that dose intensity of gemcitabine was a significant prognostic factor for PFS, whereas salvage treatment after failure of GI regimen was a significant prognostic factor for OS. Conclusions Gemcitabine and ifosfamide combination is effective and well tolerated by patients with advanced nasopharyngeal carcinoma pretreated with platinum?based chemotherapy. Further clinical study is warranted.