吉西他滨联合顺铂治疗晚期非小细胞肺癌的临床观察

Clinical observation on gemcitabine plus cisplatin regimen in advanced non-small-cell lung cancer

目的观察吉西他滨（GEM）与顺铂（DDP）方案治疗晚期非小细胞肺癌（NSCLC）的临床疗效、毒副作用。方法自2002年3月至2005年3月可评价疗效的晚期NSCLC50例，以GEM加DDP方案进行化疗，GEM1250mg／m^2。静脉滴注，第1、8天；DDP25～30mg／m^2，静脉滴注，第2～5天，每3周为1周期，2～3周期后评价疗效和毒副反应，随访1年。结果50例患者中，总有效率为48．0％，其中初治病例为50．0％，复治病例为45．0％，初、复治病例间差异无统计学意义（P〉0．05）。中位缓解期为5个月，中位生存期为9．5个月，1年生存率为61．0％。毒副作用主要是骨髓抑制，白细胞下降达Ⅲ-Ⅳ度者为36．0％，血小板下降达Ⅲ-Ⅳ度者14．0％，血红蛋白下降达Ⅲ～Ⅳ度者22．0％，其他毒副反应还有恶心、呕吐、口腔炎、脱发、静脉炎、腹泻等，但发生率均较低。结论GEM与DDP方案治疗晚期NSCLC，疗效好,毒副反应可以耐受。

Objective To observe the efficacy, toxicity of gemcitabine and cisplatin（GP） regimen in advanced non-small-cell lung cancer. Methods From March 2002 to March 2005, 50 cases of advanced non-small cell lung cancer were treated by chemotherapy of gemcitabine 1250 mg/m^2 iv dl, 8 and cisplatin 25 mg/m^2 iv d2-5, and repeated every 21 days, then to evaluate the efficacy, toxicity and survival after two or three cycles. Results Among the 50 patients, the total response rates（RR） was 48.0 %, the RR was 50.0 % in cases without previous chemotherapy, and the RR of treated cases was 45.0 %, they had no marked differences （P 〉0.05）. The median follow up time was five months. The median survival time was nine point five months, one year survival rate was 61.0 %. The major toxicity is bone marrow restrain, the leucocyte decline of Ⅲ-Ⅳ degrees is 36.0 %, the platelet decline of Ⅲ-Ⅳ degrees is 14.0 %, the hemoglobin decline of Ⅲ-Ⅳ degrees is 22.0 %. In addition, there are other toxicifies including nausea/vomiting, stomatitis trichomadesis, phlebitis, diarrhea etc. The morbidity is lower. Conclusion Gemcitabine and cisplatin regimen to advanced non-small-cell lung cancer has more satisfied efficacy, the toxicity is bearable.