吉西他滨联合顺铂与长春瑞滨联合顺铂治疗晚期非小细胞肺癌的临床疗效观察

Gemcitabine plus cisplantin or Navelbine plus cisplatin for advanced non-small cell lung carcer

目的观察吉西他滨联合顺铂与长春瑞滨联合顺铂治疗晚期非小细胞肺癌的(NSCLC)的临床疗效及毒副作用。方法78例Ⅲ～Ⅳ期NSCLC患者,随机分为GP组和NP组,GP组:国产吉西他滨(泽菲)1000mg/m2,静滴,d1、d8;顺铂80mg/m2,静滴,d1,联合化疗。NP组:国产长春瑞滨(盖诺)25mg/m2,静滴,d1、d8;顺铂80mg/m2,静滴,d1,联合化疗。两个方案均为每3周一个周期。结果78例NSCLC均可评价疗效,GP组40例,完全缓解(CR)+部分缓解(PR)16例,有效率40.0%,NP组38例,CR+PR15例,有效率39.5%,两组有效率相当(P=0.985)。主要不良反应均为骨髓抑制。其中NP组的III～IV度白细胞减少和静脉炎的发生率明显高于GP组(P<0.05),GP组的III～IV度血小板减少高于NP组(P<0.05),两组的其他不良反应相近(P>0.05)。而住院费GP组高于NP组。结论吉西他滨联合顺铂与长春瑞宾联合顺铂治疗晚期NSCLC两者疗效相当,而前者不良反应发生率要低于后者,更适合老年体弱者,但费用稍贵,临床可根据不同病人选择不同方案。

Objective To investigate the efficacy and toxicity of gemeitabine plus eisplatin or Navelbine plus eisplatin for advanced non - small cell lung cancer （ NSCLC ）. Methods 78 patients with stage Ⅲ-Ⅳ NSCLC were randomly assigned to receive intravenous gemeitabine （ Zefei ） 1000 mg / m^2 at d1 and d8 and intravenous eisplatin 80 mg / m^2 at d1 （ GP group, n =40） or intravenous Navelbine （Gainuo） 25 mg / m^2 at d1 and d8 and intravenous eisplatin 80 mg/ m^2 at dl （ NP group, n = 38 ）, 3 weeks constituting a cycle. Results The results of therapy were assessed as follows： the CR ＋ PR in 16 patients, with the total response rates being 40.0% in GP group; CR ＋ PR in 15 patients, with the total response rates being 39.5% in NP group. There were no significant differences in efficacy between the two groups （ P = 0. 985 ）. The main adverse reactions were myelosuppression, but NP group had significantly more Ⅲ-Ⅳ neutropenia and phlebitis than GP group （ P 〈 0.05 ）, and GP group had significantly more Ⅲ-Ⅳ thrombocytopenia than NP （ P 〈 0. 05 ）, other adverse reactions were similar between two groups （ P 〉 0. 05 ）. The cost of GP group was higher than NP group. Conclusion The effectiveness of gemcitabine plus cisplatin and Navelbine plus cisplatin for advanced NSCLC was comparable, But the former has less adverse reactions than the latter; so gemcitabine plus cisplatin is more suitable for the elderly patients. However, its cost is higher than Navelbine plus cisplatin.