含顺铂的三种化疗方案治疗非小细胞肺癌的临床比较

Clinical Comparison of Three Different Chemotherapy Regimens Including Cisplain for Advanced Non-small Cell Lung Cancer

目的比较EP、GP、NP三种不同的化疗方案治疗非小细胞肺癌(NSCLC)的近期疗效和毒副反应。方法157例晚期NSCLC患者分为三组,分别接受顺铂+足叶乙甙(EP方案)、顺铂+去甲长春花碱(NP方案)或顺铂+吉西他滨(GP方案)治疗,EP组42例,NP组56例,GP组59例,观察近期疗效和毒副反应。结果①EP组、NP组、GP组的有效率分别为26.2%、48.2%、52.5%,GP组、NP组疗效明显好于EP组(P=0.013,0.038),既往曾接受过化疗的患者中GP组疗效明显好于EP组(P=0.039)。②NP组白细胞减少发生率明显高于GP组(P=0.001),血小板减少发生率GP组明显高于NP(P=0.002)和EP组(P=0.033),静脉炎的发生仅见于NP组,少部分患者出现轻度肝肾功能损害,发生率三组间无显著差异。结论GP方案和NP方案对NSCLC均有良好的临床疗效,毒副作用可逆,为治疗晚期NSCLC的有效方案。

Objective To evaluate the short-time effects and toxic side-effects of EP, GP, NP regimens for patients with advanced Non-small Cell Lung Cancer （NSCLC）. Methods The 157 cases of patients with advanced NSCLC were divided into three groups, given VP-16 plus DDP （EP） regimen or NVB plus DDP （NP） regimen or GEM plus DDP （GP） regimen respectively. There were 42 patients in group EP and 56 patients in group NP and 59 patients in group GP. On the research, the short-time effects and toxic side-effects were observed. Results ①The response rate of group EP, NP and GP were 26.2% 48. 2% and 52.5% respectively. It showed that the short-time effects of the group GP and EP were better than those of group EP significantly （P = 0. 013,0.038）. In the patients who had been given chemotherapy previously, the effects of the group GP were also better than that of group EP significantly （P= t）. 039）. ①Leukopenia occurred in group NP was more pronounced than that in group GP（P = 0. 001 ）, and thrombocytopenia occurred in group GP was more pronounced than that in group NP（P= 0. 002）and EP（P = 0.033）. Phlebitis only occurred in group NP. A small part of patients had mild hepatic or renal function disorder and the occurrence had no significant difference among the three groups. Conclusion GP and NP regimens are all effective for advanced NSCLC. The toxic side-effects are reversible and pa- tients can well tolerate them.