TP与NP方案治疗晚期非小细胞肺癌的临床观察

TP and NP chemotherapy schemas for advanced stage of non-small cell lung cancer

目的:观察TP方案(紫杉醇+顺铂)和NP方案(长春瑞滨+顺铂)治疗晚期非小细胞肺癌(NSCLC)的近期疗效及毒副反应。方法:使用TP方案治疗晚期NSCLC 32例,给予紫杉醇(PTX)135mg/m2,静脉滴入,d1;顺铂(DDP)25mg/m2,静脉滴入,d1～d3。使用NP方案治疗晚期NSCLC 33例,给予长春瑞滨(NVB)25mg/m2,静脉滴入,d1,d8;DDP用法同TP方案。每3周重复,2个周期化疗后观察疗效。结果:TP方案有效率为40.6%(13/32),其中腺癌为50%(9/18),鳞癌为33.3%(4/12);NP方案有效率为39.4%(13/33),其中腺癌为35%(7/20),鳞癌为50%(5/10)。骨髓抑制及消化道反应为两者主要毒副反应,白细胞、血小板及血红蛋白减少率分别为93.8%(30/32)、37.5%(12/32)、37.5%(12/32)和75.8%(25/33)、18.2%(6/33)、42.4%(14/33);恶心、呕吐发生率分别为75.0%(24/32)和72.7%(24/33),两者差异无统计学意义。结论:TP和NP方案治疗晚期NSCLC效果均较好,但TP方案对腺癌疗效比NP方案更有优势,NP方案对鳞癌更有优势。

OBJECTIVE： To observe the near therapeutic effects and toxic reactions of TP （Toxal and Cisplatin） and NP （Vinorelbine and Cisplatin） chemotherapy schemas for advanced stage of non-small cell lung cancer. METHODS： Thirty-two patients of advanced stage NSCLC were given TP chemotherapy schema with toxal 135 mg/m^2 on d1 and DDP 25 mg/m^2 on d1 d3 , and 33 patients of advanced stage NSCLC were given NP chemotherapy schema with vinorelbine 25 mg/m^2 on d1, d8 and DDP 25 mg/m^2 on d1-d3. Each cycle was 3 weeks, and two cycles later, the therapeutic effects were abserved. RESULTS： Effective power （RR）： TP chemotherapy schema was 40.6% （13/32）, among them adeno carcinoma was 50% （9/18） and squamous cell carcinoma was 33.3%（4/12）. NP chemotherapy schema was 39.4%（13/33）, among them adenoearcinoma was 35 % （7/20） and squamous cell ear cinoma was 50% （5/10）. The main toxic reactions of them were myelosuppression and nausea. The incidence rates of decreasing of WBC, PLT, HGB were 93.8%（30/32）, 37.5%（12/32）, 37.5% （12/32） and 75.8%（25/33）, 18.2%（6/33）, 42.4%（14/33） in the 2 schemas respectively. The incidence rates of nausea and vomit were 75.0% and 72.7%, and there was no difference. CONCLUSIONS： TP and NP chemotherapy schemas for advanced stage of NSCLC have good therapeutic effects. TP chemotherapy schema is better than NP on adenoearcinoma and NP is better on squamous cell carcinoma.