甲孕酮联合长春瑞滨顺铂治疗晚期非小细胞肺癌临床观察

Effects of Navelbine and Cisplatin Combined with Megestrol Acetate on Advanced Non-small Cell Lung Cancer

目的:观察甲孕酮合并NP方案(长春瑞滨+顺铂)化疗及单用NP方案化疗治疗晚期非小细胞肺癌患者的疗效及不良反应。方法:75例接受化疗的晚期非小细胞肺癌患者随机分为单用化疗组(对照组)36例及化疗并用甲孕酮组(治疗组)39例,治疗周期均为21天,2个周期后评价疗效。结果:治疗组、对照组有效率(CR+PR)分别为43.59%(17/39例),41.67%(15/36例),中位疾病进展期分别为4.0、3.6个月,中位生存期分别为9.1、8.9个月;1年生存率分别为38.5%、38.9%;差异无统计学意义(P>0.05);主要不良反应是Ⅲ～Ⅳ度骨髓抑制、恶心呕吐。治疗组的白细胞减少(7.69%)、血红蛋白下降(0)、血小板减少(7.69%)发生率与对照组(25.00%、19.44%、13.89%)比较差异有统计学意义(P<0.05);治疗组的恶心呕吐发生率为0,显著低于对照组(13.89%)。化疗后治疗组生活质量改善明显并优于对照组,差异具有统计学意义(P<0.05)。结论:甲孕酮合用长春瑞滨联合顺铂治疗晚期NSCLC疗效较高,毒副反应轻,患者耐受良好。

Objective： To evaluate the effects of Navelbine and Cisplatin combined with Megestrol Acetate on patients with stage Ilia and IV non-small cell lung cancer （NSCLC）. Methods： A total of 75 patients with advanced NSCLC were randomly divided into two groups： the trial group （Navelbine and Cisplatin combined with Megestrol Acetate） and the control group （Navelbine and Cisplatin）. The chemotherapy was repeated every 21 days, and the effects were analyzed and compared after two cycles were finished. Results： The response rates were 43.59%（17/39） in the trial group and 41.69% （15/36） in the control group. The median survival time was 9.1 months in the trial group and 8.9 months in the control group. The median TTP was 4 months in the trial group and 3.6 months in the control group. The 1-year survival rate was 38.5% in the trial group and 38.9% in the control group, without significant difference （P〉0.05）. The major adverse reactions were stage 3 to stage 4 myelosuppression, nausea and vomiting. The incidence of leucopenia, anemia and thrnmboeytopenia was 7.69%, 0% and 7.69% in the trial group and 25.00%, 17.44%, and 13.89% in the control group, respectively（P〈0.05）. Improvement in quality of life was greater in the trial group than in the control group（P〈0.05）. Conclusion： Megestrol Acetate can effectively improve the eMcacy of the chemotherapy regimen with Navelbine and Cisplatin in patients with advanced NSCLC. And without causing significant side effects, Megestrnl Acetate can improve the quality of life of patients with advanced NSCLC.