健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的比较

A comparison between 3-week and 4-week schedule of gemcitabineplus cisplatin for advanced non-small cell lung cancer

目的比较健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的疗效和不良反应。方法38例入选病人均为经病理和细胞学证实的晚期非小细胞肺癌,既往未进行化疗和放疗,临床上有可测量病灶(根据WHO标准),ECOG评分为0～2分,肝肾功能基本正常。3周方案组(15例)健择给药时间为第1天和第8天,剂量为1250mgm2,静脉滴注30分钟;顺铂给药时间为第1天,剂量为75mgm2,静脉滴注。4周方案组(21例)健择给药时间为第1天、第8天和、第15天,剂量为1000mgm2,静脉滴注30分钟;顺铂给药时间为第1天,剂量为75mgm2或100mgm2,静脉滴注。结果4周方案组中22例可评价疗效,其中11例PR(50%)、5例SD(22.7%)和6例PD(27.3%);3周方案组中11例可评价疗效,其中5例PR(45.5%)、4例SD(36.4%)和2例PD(18.2%),两组比较无显著差异。4周方案组的中位生存期为8.6个月(2.7～19.1);3周方案组的中位生存期为9.1个月(2.7～11.1),两组无显著差异。主要不良反应是白细胞、中性粒细胞、血小板和血红蛋白减少等血液学毒性,两组间的反应无显著差异。结论健择是有效的抗肿瘤药物,3周方案与4周方案的疗效相似。

Objective To compare the efficacy and side effects between 3-week and 4-week schedule of gemcitabine plus cisplatin for advanced non-small cell lung cancer.Methods The following patients were enrolled:chemonaive NSCLC patients with pathology or cytology proved;ECOG physical status 0-2;measurable lesions and good liver and renal function.Patients received 3-week or 4-week schedule chemotherapy.Results A total 38 patients were enrolled,23 for 4-week schedule and 15 for 3-week schedule with the same geographical characters.22 were evaluable in 4-week schedule group:partial remission(PR)11(50%),stable disease(SD)5(22.7%)and progress disease(PD)6(27.3%);11 were evaluable in 3-week schedule:PR 5(45.5%)?SD 4(36.4%)and PD 2(18.2%),and no significant difference was found.The madian survial was 8.6(2.7～19.1)months in 4-week schedule group,and 9.1(2.7～11.1)months in 3-week schedule.The main side effects found were leucocytopenia,granocytopenia,thrombocytopenia,anorexia and nausea,which happened with lower frequency in 3-week schedule group than in 4-week schedule group without significant difference.Conclusion Gemcitabine was an active anti-cancer medicine.The similar efficacy were found in two group and less side effects in 3-week schedule than 4-week schedule.