泰素蒂加顺铂治疗进展期NSCLC的临床研究

Clinical study of taxotere and cisplatin regimen in advancing non- small cell lung cancer

目的观察泰素蒂加顺铂方案治疗进展期非小细胞肺癌的临床疗效、毒副作用。方法收集可评价疗效的进展期非小细胞肺癌50例,以泰素蒂加顺铂方案进行化疗,泰素蒂75 mg/m2静脉滴注,第1天;顺铂25 mg/m2～30 mg/m2静脉滴注,第2天～第5天,每3周为一个周期,2～3周期后评价疗效和毒副反应并随访。结果50例患者中,总有效率为50.0 %,其中初治病例为53.1 %,复治病例为44.4 %,初复治病例间差异无显著性(P >0.05)。中位缓解期为5个月。中位生存期为9.5个月,1年生存率为61.0 %。毒副反应主要为骨髓抑制,白细胞下降达Ⅲ度、Ⅳ度者52.0 %,血小板下降达Ⅲ度、Ⅳ度者为14.0 %。血红蛋白下降不严重。其他毒副反应还有脱发、过敏反应、水钠潴留、静脉炎、末梢神经炎、口腔炎、腹泻等,但发生率均较低。结论泰素蒂加顺铂方案治疗进展期非小细胞肺癌,特别是复发病例,临床疗效比较满意,毒副反应能够耐受。辅以G蛳CSF可防治重度的骨髓抑制,有较好的临床应用价值。

Objective To observe the efficacy, toxicity and survival of Taxotere and Cisplatin regimen in advanced non?- small cell lung cancer. Methods From March 1998 to December 2003, 50 cases of the advanced non?- small cell lung cancer was treated by chemotherapy of Taxotere and Cisplatin regimen for two or three cycles, then to evaluate the efficacy, toxicity and survival. Results Among this group of 50 cases patients, the total response rate(RR) was 50.0 %. The RR was 53.1 % in cases without previous chemotherapy, and the RR of pretreated cases was 44.4 %, they have no marked difference (P >0.05). The median follow up time was five months. The median survival time is nine point five months, One year survival rate was 60.0 %. The major toxicity is bone marrow restrain, the leucocyte decline of Ⅲ～Ⅳ degrees is 52.0 %, the platelet decline of Ⅲ～Ⅳ degrees is 14.0 %. In addition, there are another toxicities: trichomadesis, allergic reaction, edema, phlebitis, peripheral neuritis, stomatitis, diarrhea and so on, the morbidity is lower. Conclusions Taxotere and Cisplatin regimen to treat advanced non?- small cell lung cancer had more satisfied efficacy, the toxicity were tolerant, if G?- CSF was used to defend and treat the serious bone marrow restrain, it might have better value.