NP和GP方案治疗晚期非小细胞肺癌的疗效比较

Vinorelbine plus cisplatin versus gemcitabine plus cisplatin in patients with advanced NSCLC

目的 诺维本加顺铂（NP）和健择加顺铂（GP）方案均是目前治疗晚期非小细胞肺癌的常用方案，本研究对两种方案进行了有效率、存活率和不良反应等方面的比较。方法 自1999～2004年，总共80例晚期非小细胞肺癌（Ⅲb期或Ⅳ期）参与研究，采用NP方案治疗40例、GP方案40例，比较其疗效及不良反应。结果 总有效率NP方案为27．5％，GP方案为22．5％（P〉0．05）；平均存活时间NP方案为9．4个月，GP方案为8．6个月（P〉0．05）；1年存活率NP方案为10．0％，GP方案为7．5％（P〉0．05）。两种方案的主要不良反应均为骨髓抑制，白细胞下降至Ⅲ、Ⅳ度者NP方案为45％，GP方案为40％（P〉0．05）；化疗后出现Ⅲ、Ⅳ度便秘者NP方案为25．0％，GP方案为7．5％（P〈0．05）。结论 NP方案和GP方案治疗晚期非小细胞肺癌效果确实，且较一致，耐受性均较好，但使用NP方案要注意预防便秘。

Objective The combinations of vinorelbine plus cisplatin（NP） and gemcitabine plus cisplatin（GP） are good regimens used in the treatment of advanced non-small cell lung cancer（NSCLC）. To compare the response rate, survival rate and toxicity of the two regimens. Methods From 1999 to 2004,80 patients with a mean age of 56.2 years （range 26-77 years）with Ⅲ b/Ⅳ stage NSCLC were treated with vinorelbine （VNR,25mg/m^2） on ld and 8d and cisplatin （CDDP,30mg/m^2） on ld,2d and 3d or gemcitabine （GEM, 1 000mg/m^2 ） on ld and 8d and cisplatin （CDDP,30mg/m^2 ） on 1d,2d and 3d,in repeated cycle of 21d. Fourty patients （group A） received NP and 40（group B） received GP. Results In group A, there were 1 complete recovery（CR） and 10 partial recovery（PR） with the overall response rate （ORR） of 27.5%, compared with 9 PR and ORR of 22.5% in group B（P〉0.05）. Mean survival times were 9.4 months in group A and 8.6 months in group B（P〉0.05）. One-year survival rates for group A and B were 10.0% and 7.5% respectively. The main side effects came from the inhibition on the bone marrow. The grade Ⅲ , Ⅳ of leukopenia in group A and B were 45.0% and 40.0% respectively. There was no significant difference between the two groups（P〉0.05）. The grade Ⅲ , Ⅳ of constipation in group A and B were 25.0 % and 7.5 % respectively. There was significant difference between the two groups（P〈0.05）. Conclusion Both NP and GP are tolerable regimens with good efficacy for advanced NSCLC patients.