异长春花碱联合顺铂方案治疗晚期非小细胞肺癌的临床观察

Clinical study of navelbine combined with cisplatin in the treatment of advanced non-small cell lung cancer

目的 观察异长春花碱 (NVB)和顺铂 (DDP)联合化疗方案治疗晚期非小细胞肺癌 (NSCLC)的疗效及毒副反应。方法 自 1998年至 2 0 0 3年对 46例中晚期NSCLC进行NVB +DDP联合化疗 ,NVB2 5mg/m2 ,第 1、8天用 ,DDP 65～ 80mg/m2 第 1天或分三天用 ,2 1天为一个周期 ,至少应用两个周期。结果 全组有效率为 47.8% (2 2 / 46) ,其中初治患者有效率为 5 1.6% ,复治患者有效率为 40 .0 % ;ⅢB期有效率为5 4.5 % ,Ⅳ期有效率为 41.7% ;腺癌有效率为 5 0 .0 % ,鳞癌有效率为 44 .4% ;中位生存期为 9.5个月 ,1年生存率为 3 9.1%。化疗毒性主要为骨髓抑制、恶心呕吐及静脉炎。白细胞下降率为 95 .7% ,其中Ⅲ +Ⅳ度为2 8.3 % ,恶心呕吐发生率为 47.8% ,其中Ⅲ +Ⅳ度为 8.7% ,静脉炎发生率为 19.6% ,但均为Ⅰ、Ⅱ度。结论 NVB +DDP方案治疗晚期NSCLC疗效较好 ,毒副反应可以耐受。

Objective To evaluate the efficacy and toxicity of combination chemotherapy with navelbine (NVB) and cisplatin (DDP) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods From 1998 to 2003, 46 patients with advanced NSCLC were treated with NVB plus DDP. NVB was given at a dose of 25 mg/ m 2 on day 1 and 8, DDP at a dose of 65--80 mg/m 2 on day 1 or days 1--3. Twenty-one days was one cycle, each patient was treated at least for two cycles. Results The overall response rate (RR) was 47.8% (22/46), 51.6% (16/31) for the first treated cases and 40.0% (6/15) for the retreated cases. RR of stage ⅢB and Ⅳ was 54.5% (12/22) and 41.7% (10/24) respectively. RR for adenocarcinoma and squamous cell carcinoma was 50.0% (14/28) and 44.4% (8/18) respectively. The median survival time was 9.5 months. One-year survival rate was 39.1%. The common toxicities were myelosuppression, nausea/vomiting and phlebitis. Neutropenia accounted for 95.7% (grade Ⅲ+Ⅳ was 28.3%), nausea/vomiting for 47.8% (grade Ⅲ+Ⅳ was 8.7%) and phlebitis for 19.6%, but the last one were mild. Conclusion Combination chemotherapy with NVB and DDP is an effective regimen to treat advanced NSCLC, and the toxicities are to-lerable.