铂类为基础的三种化疗方案治疗晚期非小细胞肺癌的临床研究

Clinical study of three platinum-based regimens in the combined chemotherapy of patients with advanced NSCLC

目的:观察紫杉醇(paclitaxel,Taxel)、长春瑞滨(vinorelbine,NVB)、吉西他滨(gemcitabine,GEM)分别联合顺铂(cisplatin,DDP)方案对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及毒副反应。方法:93例晚期非小细胞肺癌患者随机分为TP组(紫杉醇+顺铂)32例、NP组(长春瑞滨+顺铂)31例、GP组(吉西他滨+顺铂)30例。给药方法:紫杉醇135mg/m2,第1天;长春瑞滨25mg/m2,吉西他滨1000mg/m2,均在第1、8天使用;顺铂80mg/m2,分2天使用。统计各组有效率(CR+PR)、中位生存期(median duration of survival)、1年生存率(1 year survival rate)。结果:TP组有效率(CR+PR)为43.8%,中位生存期为8.6月,1年生存率为32.1%;NP组有效率为38.7%,中位生存期为8.4月,1年生存率为26.5%;GP组有效率为36.7%,中位生存期为9.4月,1年生存率为38.1%,三组间疗效无显著差异(P>0.05)。主要不良反应为骨髓抑制、消化道反应,均可耐受。TP组骨髓抑制发生率相对较高,NP组静脉炎发生率高于TP、GP组,有显著性差异(P<0.05)。结论:三种联合化疗方案对晚期NSCLC疗效确切,三种方案间无显著差异,均可作为一线化疗方案在临床应用。

Objective： To observe the effect and toxicity of TP, NP and GP regimen in the chemotherapy of patients with advanced non -small cell lung cancer （NSCLC）. Methods： Total of 93 cases of advanced NSCLC patients were divided into TP group（31 cases） ,NP group（31 cases） and GP group（31cases） randomly. The patients were treated respectively with paclitaxel 135mg/m^2, dl ; vinorelbine 25mg/m^2, d1, 8 ; gemcitabine 1000mg/m^2, d1, 8 ; cisplatin 80mg/m^2 ,d1,2. The reponse rate, median duration of survival and 1 year survival rate were calculated finally. Resuits： The reponse rate was 43.8% in TP group,38.7% in NP group,36.7% in GP group;The median duration of survival were 8.5,8.3 and 9.4 months respectively;the 1 year survival rate were 29.4% ,23.6% , and 38.1% respectively. The efficacy in three groups had no significant difference （ P 〉 0. 05 ）. The major toxicities were bone marrow suppression and gastrointestinal toxicity. The rate of bone marrow suppression of TP group was higher than the other groups, and the NP group had a higher rate of phlebitis than TP and NP. Conclusion ： TP, NP and GP regimens are definitely effective in NSCLC patients. There is no significant difference among the three groups. They all can be used as the first line therapy protocols for the treatment of advanced NSCLC patients.