晚期非小细胞肺癌内科治疗的探讨

Internal medical approaches in management of patients with non small cell lung cancer at end stages

目的观察健择顺铂、泰素顺铂、泰索帝顺铂、易瑞沙治疗晚期非小细胞肺癌的疗效、毒副反应及费用情况。方法经病理学证实的99例晚期非小细胞肺癌患者分成四组。A组健择1000mgm2d1,8,15+顺铂100mgm2d1,4周为1个周期,连用4个周期;B组泰素135mgm2d1+顺铂75mgm2d2,3周为1个周期,连用4个周期;C组泰索帝75mgm2d1+顺铂75mgm2d1,3周为1个周期,连用4个周期;D组易瑞沙250mg,每日1次,30d为1个周期,连用6个周期。结果总有效率A组为23.3%,B组21.4%,C组26.0%,D组23.5%;中位生存期A组为8.1个月,B组7.8个月,C组8.0个月,D组7.6个月;毒副反应A、B、C三组骨髓抑制及消化道症状比较常见,但三组间无明显的差异性(P>0.05),而D组这些毒副反应则明显减少;费用D组最高,其次为C组,A、B两组相当。结论选择A、B组比较适合于普通群众,而对于经济条件比较好的或者不能耐受化疗药物毒副反应的病人可选用易瑞沙。

Objective To observe the efficacy and side effects and spend ofgemcitabin/eisplatin,taxol/eisplatin, taxotere/cisplatin and iressa in the treatment of patients with advanced non small cell lung cancer.Methods Ninety - nine patients of advanced non small cell lung cancer were divided into 4 groups. Group A： gemcitabin 1 000 mg/m^2 ,d1.8.15 ＋ cisplatin 100 mg/m^2 ,d1 ,per 4 weeks repeat × 4 cycle ;Group B： taxol 135 mg/m^2 ,d1＋ cisplatin 75 mg/m^2 ,d2 ,per 3 weeks repeat × 4 cycle;Group C： taxotere 75 mg/m^2 ,d1 ＋ cisplatin 75 mg/ m^2 ,d1 ,per 3 weeks repeat ×4 cycle;Group D：iressa 250 mg/d,30 days for one period × 4 cycle.Result All efficacy：group A 23.3%,group B 21.4%,group C 26.0%,group D 23.5 %;Median survival period：group A 8.1 months, group B 7.8 months,group C 8.0 months,group D 7.6 months;Toxicities： myelogenous check and digestion tract symptom of group A,B and C were higher than group D,but there was nothing different in the three groups （P〉0.05）.Spend：group D was the highest,group C was higher, group A was as much as group B. Conclusion Group A and B is fitter general people than group C and B ; But fire rich patients or whom don＇t bear the toxicity of drugs may choice iressa.