The Clinical Observation Of Gemcitabine Plus Vinorelbine For Second-Line Treatment Of Metastatic Nasopharyngeal Carcinoma

Objective:To evaluate the efficacy and safety of gemcitabine plus vinorelbine for second-line treatment of patients with metastatic nasopharyngeal carcinoma previously treated with platinum-based chemotherapy.Methods:From January 2010 to March 2016 in our hospital,a total of forty-one eligible patients with metastatic nasopharyngeal carcinoma who were treated with platinum-based chemotherapy,they received gemcitabine 1000 mg/m2 infused intravenously 30 min on day 1 and day 8,vinorelbine 25mg/m2 infused intravenously on day 1 and day 8,and each 21 days as a cycle.Survival analysis was estimated with Kaplan-Meier curves.Log-rank test was used to compare the univariate analysis.And multivariate stratification was analyzed by COX proportional hazard model.Results:(1)In this study,41 patients completed 146 cycles of chemotherapy, with the median number of cycles was 4 and the rang was from 1 to 8.Among the 41 patients,35 were assessable for response,the overall response rate was 42.9%, the disease control rate was85.8%.(2)The follow-up duration of all 41 patients were 5.0-38.6 months,and the median follow-up duration was 9.5 months,the median progression-free survival was 6.0 months (95%CI,4.4-7.6 months) and the median overall survival was 16.4 months(95%CI,8.8-24.0 months). (3)The main adverse reactions were bonemarrow suppression, Ⅲ-Ⅳ degree leucopenia was reported in 36.6%, neutropenia in 29.3% and thromocytopenia in 4.9%.(4)Univariate analysis indicated that the cycles of chemotherapy(<4 or≥4) and nasopharyngeal carcinoma initially presenting with distant metastasis were the prognostic factors of metastatic nasopharyngeal carcinoma.In multivariate analysis,the cycles of chemotherapy were independently significant negative prognostic factor.Conclusion:(1)This study demonstrated that it had a certain effect for gemcitabine and vinorelbine combination for patients with metastatic nasopharyngeal carcinoma previously treated with platinum-based chemotherapy. (2)The adverse reactions were well tolerated.