国产紫杉醇联合顺铂治疗晚期非小细胞肺癌40例疗效观察

Combination chemotherapy of domestic paclitaxel plus cisplatin in treatment of advanced non-small cell lung cancer

目的：观察国产紫杉醇联合顺铂治疗Ⅲ～Ⅳ期非小细胞肺癌（non-small cell lung cancer，NSCLC）的近期疗效、毒副反应及恶性肿瘤相关物质（tumor supplied group of factors，TSGF）的变化。方法：初治的Ⅲ～Ⅳ期NSCLC患者40例，以国产紫杉醇135ms／m^2，静脉滴注，d1，顺铂30ms／m^2，静脉滴注，d1～d3，连用2个周期后评价疗效，TSGF应用生化比色法检测。结果：全组35例可评价，部分缓解（PR）15例，稳定（SD）12例，进展（PD）8例，有效率（CR＋PR）为42．9％。主要毒副反应为胃肠反应（Ⅲ～Ⅳ级为11．4％）和血液学毒性（Ⅲ-Ⅳ级白细胞下降为14．2％）。在治疗有效的患者中治疗后TSGF明显下降（P〈0．001），而在治疗无效的患者中治疗后TSGF无明显下降（P〉0．05）。结论：国产紫杉醇联合顺铂治疗NSCLC有较好疗效，毒性较小，TSGF可作为肺癌治疗疗效的评价依据之一。

Objective：To evaluate the efficacy and toxicity reactions of domestic paclitaxel plus cisplatin in the treatment of advanced non-small cell lung cancer（NSCLC）. Methods： Forty previously untreated patients with advanced NSCLC were selected and domestic paclitaxel was given at a dose of 135 mg/m^2 on day 1 and cisplatin at a dose of 30 mg/m^2 on day 1 to 3. The chemotherapy was repeated every 21 days with two cycles. Tumor supplied group of factors（TSGF） was measured by biochemical method. Results： The overall response rate was 42.9%. The main maintoxicity reactions were nausea/vomiting （ 11.4% were in grade Ⅲ to Ⅳ ） and hematologic toxicity（the prevalence of grade Ⅲ to Ⅳ leukopenia decreased to 14.2% ）. The serum level of TSGF decreased significantly （P 〈 0. 001 ） in the response patients after two cycles of chemotherapy but the change of serum level of TSGF was not obvious in the nonresponse patients. Conclusions：The combination therapy of paclitaxel plus cisplatin is a highly effective regimen for patients with advanced NSCLC with a manageable toxicity.