Objective To explore the efficacy and adverse reactions of gemcitabine combined with nedaplatin followed by sequential palliative radiotherapy for treatment of recurrent nasopharyngeal carcinoma.Methods A total of 170 patients with recurrent nasopharyngeal carcinoma in PLA 175th Hospital from Nov.2012 to Dec.2013 were collected,and divided into an observation group and a control group by random number method,85 cases in each group.The observation group was given gemcitabine combined with nedaplatin followed by sequential palliative radiotherapy,while the control group was given cisplatin combined with fluorouracil followed by synchronization palliative radiotherapy.The tumor volume,the symptom improvement,two-year local progression-free survival,no-distant metastasis survival rate,total efficacy,life quality improvement and adverse reactions of the two groups were compared after treatment.Results After treatment,the improvement rate of rhinocleisis,tinnitus and blood nasal discharge of the observation group were lower than those of the control group(P ＜0.05).The tumor volumes of the two groups were reduced after treatment,and the observation group was less than that of the control group [(42.6 ± 9.7) mm3 vs (68.7 ± 13.1) m m3] (P ＜ 0.01).The disease control rate,treatment efficacy [92.94％ (79/85) vs 65.88％ (56/85),69.41％ (59/85) vs 43.53％ (37/85)] and clinical curative effect of the observation group were higher than those of the control group (P ＜ 0.05).Two-year local progression-free survival,no-distant metastasis survival rate of the observation group were higher than those of the control group [85.88％ (73/85) vs 68.23％(58/85),70.59％ (60/85) vs 40.00％ (34/85),P ＜0.05].Life quality scores of different dimensions were higher after treatment,while the observation group improved more significantly than the control group (P ＜0.05).Observation group's incidences of degree Ⅲ/Ⅳ of mucositis,skin reactions,bone marrow suppression and gastrointestinal reactions were significantly lower than those of the control group[7.06％ (6/85) vs 18.82％ (16/85),1.18％ (1/85) vs 8.23％ (7/85),2.35％(2/85) vs 10.59％(9/85),12.94％(11/85) vs 15.29％(13/85)] (P＜0.05).Conclusion The efficacy of gemcitabine combined with nedaplatin followed by sequential palliative radiotherapy for treatment of recurrent nasopharyngeal carcinoma is good,which can significantly improve the clinical symptoms,reduce the incidence of adverse reactions,increase the survival rate,and improve the quality of life.%目的 探讨吉西他滨联合奈达铂化疗后序贯行姑息性放疗治疗复发性鼻咽癌患者的疗效及不良反应.方法 选取2012年11月至2013年12月解放军第一七五医院收治的170例复发性鼻咽癌患者,按照随机数字法将患者分为观察组和对照组,每组85例.观察组治疗采取吉西他滨联合奈达铂化疗后序贯行姑息性放疗,对照组采用顺铂联合氟尿嘧啶化疗后同期行姑息性放疗.比较两组患者治疗后肿瘤体积的变化、症状改善情况、2年局部无进展生存率、远处转移生存率总有效率、疗效、生活质量改善情况及不良反应发生情况.结果 治疗后,观察组有鼻塞、耳鸣及血涕症状的改善率均低于对照组(P＜0.05);治疗后两组患者治疗后肿瘤体积均较治疗前降低,且观察组小于对照组[(42.6±9.7) mm3比(53.7±9.9) mm3](P＜0.01);观察组患者的疾病控制率、治疗有效率[92.94％(79/85)比65.88％(56/85),69.41(59/85)比43.53％ (37/85)]以及临床疗效均高于对照组(P＜0.05),观察组2年局部无进展生存率、无远处转移生存率均高于对照组[85.88％ (73/85)比68.23％(58/85)、70.59％(60/85)比40.00％ (34/85)](P＜0.05).治疗后,观察组的生活质量各维度评分更高,改善更显著(P＜ 0.05).观察组患者Ⅲ/Ⅳ度黏膜炎、皮肤反应、骨髓抑制、胃肠道反应的发生率低于对照组[7.06％(6/85)比18.82％(16/85)、1.18％(1/85)比8.23％(7/85)、2.35％(2/85)比10.59％(9/85)、12.94％(11/85)比15.29％ (13/85)] (P ＜0.05).结论 吉西他滨联合奈达铂化疗后序贯行姑息性放疗治疗复发性鼻咽癌患者的效果较好,能较明显改善患者的临床症状,降低不良反应发生率,提高生存率,改善生活质量.
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