吉西他滨联合顺铂或卡铂治疗晚期非小细胞肺癌的近期疗效

Gemcitabine plus cisplatin vs gemcitabine plus carboplatin in patients with adva nced non-small-cell lung cancer

目的 :观察吉西他滨 (gemcitabine)联合顺铂与吉西他滨联合卡铂治疗晚期非小细胞肺癌的疗效和毒性反应。方法 :10 6例经病理组织学或细胞学证实的晚期非小细胞肺癌患者分为GP和GC两组 ,GP组应用吉西他滨 10 0 0mg/m2 ,静滴 ,第 1、8天 ;顺铂 30mg/m2 ,静滴 ,第 1～ 3天。GC组应用吉西他滨 10 0 0mg/m2 ,静滴 ,第 1、8天 ;卡铂ACU =5 ,静滴 ,第 1天。 2 1天为 1个周期 ,连用 2个周期评价疗效。结果 :GP组和GC组有效率 (CR +PR)分别为 4 8.1%和 4 4 .2 % (P >0 .0 5 ) ;中位疾病进展时间分别为 6 .8个月和 6 .2个月 (P >0 .0 5 ) ;毒性反应中GP组消化道毒副反应较GC组大 ,差异有显著性 ;骨髓毒性两组相当 ,差异无显著性。结论 :吉西他滨联合顺铂及吉西他滨联合卡铂两方案治疗晚期非小细胞肺癌疗效均较好 ,毒性反应轻微 ,患者耐受良好 ,尤其吉西他滨联合卡铂的消化道反应轻 ,患者易于接受 ,值得临床进一步研究。

Purpose:To study the efficacy and toxicity of g emcitabine/cisplatin(GP) and gemcitabine/carboplatin(GC) in patients with advanc ed non-small-cell lung cancer(NSCLC). Methods:patients for GP: gemcitabine 1 000 mg/m 2,days 1 a nd 8 plus cisplatin 30 mg/m 2 days 1-3 or GC:gemcitabine 1 000 mg/m 2 , days 1 and 8 plus carboplatin AUC=5 day 1. Cycles were repeated every 3 weeks. Results:54 patients to GP and 52 to GC. The objective response rate(CR+PR)was 48.1% for GP and 44.2% for GC. No significant differences between arms were observed in response rate. No significant differences between arms we re observed in median time to progression(6.8 months GP, 6.2 months GC).GP arm h ad a remarkably higher incidence of grade nausea/vomiting Ⅲ-Ⅳ than GC arm(P <0.05). Conclusions:GC arm did not provide a significant difference in response rate compared with GP arm, however, GC arm provided a better overall to lerability compared with GP arm. Carboplatin could be a valid alternative to cis platin in the palliative setting.