吉西他滨联合顺铂双周方案与三周方案治疗晚期非小细胞肺癌的对比研究

Trials on gemcitabine plus cisplatin semimonthly therapy versus that of triweekly therapy in advanced non-small-cell lung cancer

目的研究对比吉西他滨(泽菲)联合顺铂双周方案与三周方案治疗晚期非小细胞肺癌的疗效及不良反应。方法双周方案组35例晚期非小细胞肺癌患者,给予吉西他滨1250mg/m2,d1,顺铂60mg/m2,d1,每14天重复,至少用4周期以上评价疗效。三周方案组32例患者,给予吉西他滨1000mg/m2,d1、d8,顺铂50mg/m2,d1、d2,每21天重复1次,至少用2周期以上评价疗效。结果67例均可评价疗效,双周方案组有效率48.6%(17/35),中位生存时间34.1周,1年生存率34.3%(12/35);三周方案组有效率43.7%(14/32),中位生存时间33.3周,1年生存率34.4%(11/32)。毒副反应方面,Ⅲ-Ⅳ度白细胞下降、Ⅲ-Ⅳ度血小板下降、Ⅲ-Ⅳ度恶心呕吐在双周方案组分别为8.6%、14.3%和5.7%,三周方案组分别为15.6%、18.8%和15.6%。结论吉西他滨(泽菲)联合顺铂双周方案与三周方案治疗非小细胞肺癌的疗效大致相等,双周方案不良反应明显减少。

Objective：To compare the effect and the adverse effect of gemcitabine plus cisplatin semimonthly therapy with those of triweekly therapy in advanced non-small-cell lung cancer（ NSCLC ）. Methods：Semimonthly therapy guoup ：35 patients with advanced NSCLC were treated with gemcitabine 1 000mg/m^2 and cisplatin 60 mg/m^2 on day 1. The regimen was repeated every two weeks and normally at least four cycles. Triweekly therapy group：32 patients with advanced NSCLC were treated with gemcitabine 1 000mg/m^2 on d1, d8 ,cisplation 50mg/m^2 on d1 ,d2. The regimen was repeated every 21 days and normally at least two cycles. The evaluation was performed two weeks after the completion of chemotherapy. Results ：67 patients had evaluable lesions. The CR ＋ PR rate of semimonthly therapy group was 48.6% ,MST was 34. 1 weeks ,one-year survival rate was 34. 4%. The CR ＋ PR rate of triweekly therapy group was 43.7%, MST was 33.3weeks, one-year survival rate was 34. 4%. In semimonthly therapy group, the incidence of grade Ⅲ-Ⅳ leukopenia was 8. 6% ,the incidence of grade Ⅲ-Ⅳ thrombocytopenia was 14. 3% ,the incidence of grade Ⅲ-Ⅳ GI discomfort was 5.7%. In triweekly therapy group ,the incidence of grade Ⅲ-Ⅳ leukopenia was 15.6% , the incidence of grade Ⅲ-Ⅳ thrombocytopenia was 18. 8% ,the incidence of grade Ⅲ-Ⅳ GI discomfort was 15.6%. Conclusion：The efficacy of gemcitabine plus cisplatin semimonthly therapy is the same as that of triweekly therapy in advanced NSCLC. The former has less adverse effect than that of the latter.