托瑞米芬协同EP方案对耐药非小细胞肺癌的影响

The effect of TOR combined with EP regimen to resistant NSCLC

目的 研究托瑞米芬(TOR)联合鬼臼乙叉甙-顺铂(EP)方案,对耐药的且P-gp表达阳性的非小细胞肺癌(non-small cell lung cance,NSCLC)的逆转作用,为提高化疗效果提供新方法。方法应用RT-PCR方法检测耐药的NSCLC患者外周血,P-gp阳性的38例随机分两组,逆转组应用TOR 60mg,2次/日,1-7天后采用EP方案化疗;对照组仅用口方案治疗。结果(1)逆转组PR 7例,NC 9例,PD 3例,有效率为36.8％(7/19),中位生存期为9.2个月,1年生存率为42.1％;(2)对照组NC 8例,PD 11例,有效率为0,中位生存期为4.2个月,1年生存率为26.3％;(3)两组在有效率(x2=8.58,P<0.005)、中位生存期(t=2.56,P<0.01)方面差异显著;(4)逆转组P-gp转阴率为47.4％(9/19),对照组无转阴者;(5)毒副作用方面,主要为骨髓抑制和消化道反应。一般患者均可耐受。结论TOR与EP方案联合对耐药的NSCLC患者具有显著的协同抗肿瘤效应,TOR是良好的肿瘤耐药逆转药物。

Objective To investigate the effect of TOR combined with EP regimen to resistant NSCLC, in order to provide the new chemotherapy methods. Methods To test the blocd of the patients by RT - PCR. The patients who were posotive in P- gp were divided into 2 groups randomly. To the conversing set, useing EP followed with TOR (60 mg Bid per day) after 1-7 days. To the comparison sot, useing EP only. Results 1 There were 7 PR, 9 NC, 3 PD in RIS, and the response rate was 36.8%, the media survival time was 9.2 months. The rate of one year's survival time of all patients was 42.1%. 2 There were 8 NC, 11PD in the comparison set, and media survival time was 4.2 months. The rate of one year's survival time was 26.3%. 3 There are obvious differences in the rate of response rate (x2 = 8.58, P < 0.005) and the media survival time (t = 2.56,P<0.01). 4 The rate of reversing to negative set was 47.4% in the reversing group. There is no change in comparison set. 5 The main adverse effect was myelosuppression and gastrointestinal adverse effect, most patients can tolerate well. Conclusion The regimen of TOR combined with EP has obvious effect to the DR patients of NSCLC, and TPR is a better regimen to converse DR of cancer.