PGV方案与GV方案治疗晚期非小细胞肺癌的疗效比较

Comparison of PGV and GV regimen in treatment of advanced non-small cell lung cancer

目的：比较以铂类为基础的三药方案与不含铂类的两药方案治疗晚期非小细胞肺癌（NSCLC）的近期疗效和不良反应,为临床治疗提供指导.方法：24例Ⅲ～Ⅳ期NSCLC采用PGV方案（顺铂＋健择＋长春瑞滨）化疗,31例Ⅲ～Ⅳ期NSCLC采用GV方案（健择＋长春瑞滨）化疗.两方案均每3周重复,至少2个周期.结果：两组有效率、中位缓解期相近,A、B两组中位生存期分别为11个月、10个月,1年生存率分别为41.7%、41.9%.结论：铂类方案与非铂类方案治疗晚期NSCLC疗效相近（P＞0.05）,非铂类方案不良反应较铂类方案为轻,均可耐受.21天GV方案更安全、更经济,推荐作为治疗NSCLC的一线方案.

Objective： From January 2000 to December 2002, three-drug, platinum-based regimen （ PGV ） ： [ cisplatin （DDP） ＋ gemcitabine （GEM） ＋ vinorelbine （VNB） ] and two-drug combination without a platinum drug （GV） ： [ gemcitabine （GEM） ＋ vinorelbine （VNB） ] had been used to treat 55 patients with advanced non-small cell lung cancer （NSCLC）. The response and major adverse reaction were analyzed and compared. Methods ： Twenty-four cases of advanced NSCLC （ stage Ⅲ-Ⅳ ） patients were treated with PGV （DDP 35mg/m^2 d1 -d3; GEM 1 250mg/m^2 d1 ,d8 ）. The other 31 cases were treated with GV （GEM 1 250mg/m^2 d1 ,d8; VNB 25mg/m^2 d1 ,d8 ）. The two regimens were repeated every 3 weeks for 6 courses. Results：In PGV group, the overall response rate was 45.8% （CR ＋ PR = 11 ）, medium response time was 5.5 months, medium survival time was 11 months and 1-year survival rate 41.7%. In GV group, the overall response rate was 48.4% （CR ＋PR = 15）, medium response time, survival time and 1-year survival rate were 6.5, 10 months and 41.9%, respectively. The major toxicities were nausea/vomiting, myelosuppression in PGV group, myelosuppression and phlebitis in GV group, respectively. Conclusion：PGV and GV regimen for advanced NSCLC have similar response rate （P 〉 0. 05 ）. Two-drug combination without a platinum drug is less toxic than three-drug, platinum-based regimen. GV can be used as first-line treatment of advanced NSCLC.