HMVP与HVP方案治疗晚期非小细胞肺癌前瞻研究

A Prospective Randomized Study of Curative Effects of HMVP and MVP Regimens on Advanced Non-small Cell Lung Cancer

目的:观察羟基喜树碱(Hydroxycamptothecin,HCPT)联合丝裂霉菌(Mitomycin,MMC)、长春花碱酰胺(Vindesine,VDS)、顺铂(Cisplatin,DDP)组成的HMVP和HVP方案治疗晚期NSCLC的近期、远期疗效和毒副反应。方法:将90例NSCLC患者分为HMVP组和HVP组,观察各组的近期和远期疗效、毒副反应和对生存期的影响。结果HMVP组和HVP组有效率分别为39.54％(17/43)和26.19％(11／42),二组之间的疗效差异无显著性意义(P>0.05),但HMVP组有效率比HVP组高13.53％;HMVP组和HVP组中位缓解期均为19周;中位生存期为37周和36周;一年生存率为26.09％和27.27％,二年生存率为8.69％和11.36％。二组之间的中位缓解期、中位生存期、一年和二年生存率无明显差别。HMVP组和HVP组Ⅲ+Ⅳ白细胞抑制率分别为45.56％(21／46)和36.36％(16／44)、Ⅲ+Ⅳ恶心呕吐发生率为34.78％(16／46)和29.55(13／44)％、Ⅲ+Ⅳ便秘发生率为34.78％(16／46)和27.27％(12／44);二组之间的差异均无显著意义(P>0.05)。结论:HMVP方案治疗晚期NSCLC疗效比HVP方案高13.35％,而远期疗效相似,毒性可耐受,所以在NSCLC化疗时优选择HMVP方案仍需慎重。

Objective To observe the curative and side effects of HMVP and HVP regimens on the patients with advanced NSCLC. Methods Ninety patients with advanced NSCLC were randomly divided into two groups: HMVP group and HVP group. The curative and side effects on the patents with advanced NSCLC were observed in both the groups. Results The effective rate was 39. 54% (17/43) in the HMVP group and 26. 19% (11/42) in the HVP group. There was insignificant difference in the effective rate between both the groups(P >0. 05). No significant difference was observed in the Grade Ⅲ and Ⅳ leukopenia, Grade Ⅲ and Ⅳ nausea and vomiting, Grade Ⅲand Ⅳ constipation, and other toxicities between both the groups (P >0. 05). The median time of remission in the patients of both the groups was 19 weeks. The median survival time in HMVP group and HVP group was 37 and 36 weeks respectively. In HMVP group and HVP group 1-year survival rates were 26. 09% and 27.27% . 2-year survival rates 8. 69% and 11. 36% respectively. Conclusion The effective rate of HMVP regimen were slightly higher than that of the HVP regimen. The long-term curative effect of HVMP group are similar to that of HVP group. HMVP regimen should be selected firstly from both the regimens to treat the patients with advanced NSCLC.