顺铂时辰给药合并羟基喜树碱治疗晚期非小细胞肺癌的临床观察

Cisplatin Chronotherapy and Non-chronotherapy Combined with HCPT in Treatment of Advanced Non-small Cell Lung Cancer

目的探索顺铂(DDP)时辰给药与常规给药合并羟基喜树碱(HCPT)治疗晚期非小细胞肺癌的疗效和副作用。方法59例Ⅲb～Ⅳ期非小细胞肺癌患者随机分为两组,顺铂时辰给药合并羟基喜树碱组(时辰化疗组)和顺铂、羟基喜树碱常规给药组(常规化疗组),两组顺铂和羟基喜树碱的剂量相同,顺铂14mg/(m2.d),羟基喜树碱6mg/(m2.d),两药连用5天,21天为1周期,时辰化疗组顺铂在18∶00用药,其他用药时间相同。每例连用两周期以上评价疗效。结果时辰化疗组PR13例,SD13例,PD4例,有效率(CR+PR)43.3%,常规化疗组PR9例,SD17例,PD3例,有效率31.0%,两组比较P=0.051。时辰化疗组中位生存期6.62个月,12个月生存率30.4%(9/30例),18个月生存率13.3%(4/30)。常规化疗组中位生存期5.06个月,12个月生存率24.1%(7/29),18个月生存率3.4%(1/29);时辰化疗组的有效率和生存期较常规组有优势。血液学毒性和消化系统等副作用两组相仿。结论顺铂时辰给药合并羟基喜树碱治疗晚期非小细胞肺癌有临床应用价值。

Objeetive To evaluate chemotherapy efficacy and toxicity of Cisplatin chronotherapy and non chronotherapy combined with HCPT on advanced non-small cell lung cancer. Methods Fifty-nine cases of stage Ⅲ b- Ⅳ advanced non-small cell lung cancer were random divided into two groups, one group treated with Cisplatin chronotherapy and HCPT regimen, the other treated with Cisplatin non chronotherapy and HCPT regimen. The dose of two drugs was the same in two groups[Cisplatin 14 mg/（m^2 · d）, HCPT 6 mg/（m2 ·d）3, two drugs were intravenous drip d1-5 ;the Cisplatin chronotherapy group, Cisplatin was given on at eighteen o＇clock , HCPT was given in routine（at half past nine）, the Cisplatin non chronotherapy group, the Cisplatin and HCPT was given in routine, the treatment was recycled every 21 days, the therapeutic effect and side-effects was evaluated over 2 cycles. Results In chronotherapy group, PR was 13 cases, SD was 13 cases, PD was 4 cases, CR＋ PR was 43.3%, in non chronotherapy group, PR was 9 cases, SD was 17 cases, PD was 3 cases, CR ＋ PR was 31.0%, （P = 0. 051 ）, In chronotherapy group, median survival time was 6. 62 months, 12 months survival rate was 30. 4% （9/ 30）, 18 months survival rate was 13. 3%（4/30）, in non chronotherapy group, median survival time was 5.06 months, 12 months survival rate was 24. 1%（7/29）, 18 months survival rate was 3. 4%（1/29）, The side effects was the same in two groups. Conclusion Cisplatin chronotherapy combined with HCPT is regarded as a valuable regimen for advanced non-small cell lung cancer,but it needs to be further studied and evaluated in randomized trial.