低剂量吉西他滨治疗晚期非小细胞肺癌的疗效观察和对肺功能的影响

Clinical observation on gemcitabine 6h prolonged infusion regimen in the treatment of advanced non-small-cell lung cancer

目的:比较低剂量吉西他滨6小时延时GP方案和常规GP方案的疗效、毒性和对肺功能的影响。方法:50例经病理或细胞学确诊的晚期非小细胞肺癌患者,随机分为延时GP方案和常规GP方案两组,其中30例患者化疗前后行肺功能检测,观察两方案疗效、毒性和对肺功能影响的差异。结果:延时组和常规组的近期有效率分别为32%和28%(P>0·05);中位疾病进展时间分别为7·4个月和7·5个月(P>0·05);1年生存率为32%和28%(P>0·05)。延时组Ⅲ-Ⅳ度的白细胞和血小板毒性均低于常规组(分别为20%vs48%,12%vs40%,P均<0·05);对肺功能的影响,延时组的FEV1/VC的升高率和TLCO的下降率亦均低于常规组(P<0·05)。结论:低剂量吉西他滨延时GP方案和常规GP方案,近期及远期疗效无统计学差异,但有更低的Ⅲ-Ⅳ度白细胞和血小板毒性;吉西他滨延时GP方案对肺功能的影响小于常规GP方案。

Objective：1. To evaluate and compare the response, toxicity and lung function in advanced non-small-cell lung cancer patients treated by different GP regimen. Methods： 1.50 patients with advanced NSCLC were randomly divided into two groups, which accepted gemeitabine 6h prolonged infusion GP regimen （25 case ） or thirty-minute infusion GP regimen （25 case ） respectively. 2. lung function of 30 patients were detected before and after chemotherapy. Results： h The response and toxicity of two group ： The response rate of 6-h prolonged infusion group was 32% , and the response rate of thirty-minute infusion group was 28% （ P〉0. 05 ） . ②Median time to progressive disease were 7.4 months and 7.5 months in 6h prolonged group and in thirty-minute group （ P〉0.05 ） ; 1-year survival rate were 32 and 28% , respectively （P 〉0. 05）.③ Hematologic toxicity： grade 3 and 4 neutropenia oecured more frequently in thirty-minute infusion group（ 48% ） compared with 6h prolonged group （20%） （P〈0. 05 ） ; grade 3 and 4 thrombocytopenia oeeured more frequently in thirty-minute infusion group （40%） compared with 6h prolonged group（ 12% ） （P〈0. 05）. 2. The effect on lung function： The rate of increase of FEVJVC and the rate of decrease of TLCO in thirty-minute infusion group were higher than those of 6h prolonged infusion group （ P〈0. 05 ）. Conclusion ： Compared with thirty-minute infusion GP regimen, 6h prolonged infusion GP regimen has less grade 3 and 4 thrombocytopenia, neutropenia and lung toxicity.