紫杉醇联合不同铂类治疗晚期非小细胞肺癌临床研究

Trials on paclitaxel injection (Taxol) plus platina agents in treating advanced non-small cell lung cancer

目的观察紫杉醇联合不同铂类治疗晚期非小细胞肺癌的疗效及不良反应。方法120例初次确诊为非小细胞肺癌患者,随机分为4组。顺铂组:给予紫杉醇175 mg/m2,顺铂80 mg/m2;卡铂组:给予紫杉醇175 mg/m2,卡铂80 mg/m2;草酸铂组:给予紫杉醇175 mg/m2,草酸铂130 mg/m2;奈达铂组:给予紫杉醇175 mg/m2,奈达铂80 mg/m2;4组均每21天重复1次,连用4周期。化疗结束2周后复查、比较4组的有效率和不良反应发生率。结果120例患者均可顺利完成4个周期化疗。顺铂组、卡铂组、草酸铂组和奈达铂组有效率分别为33.3%、30.0%、33.3%、36.7%,差异无统计学意义(P>0.05)。III-IV期不良反应对比,草酸铂组白细胞及血小板下降优于其他3组,差异有统计学意义(P<0.05),而肌肉关节疼痛、神经损害、肾功能损害及恶心呕吐差异无统计学意义(P>0.05)。结论紫杉醇联合顺铂、卡铂、草酸铂、奈达铂治疗晚期非小细胞肺癌的疗效大致相等,但草酸铂不良反应明显较少。

Objective To evaluate the effect and safety of paclitaxel injection （Taxol） plus platina agents in treating advanced non-small cell lung cancer （NSCLC）. Methods Consecutive 120 patients with advanced NSCLC were enrolled the clinical trial. The patients were randomized into four groups：the cisplatin group were treated with paclitaxel injection 175 mg/m2 dl, and then cisplatin 80 mg/m2 ; the patients in the carboplatin group were treated with paclitaxel injection 175 mg/m2, and then carboplatin 80 mg/m2 ;the patients in the oxaliplatin group were treated with paclitaxel injection 175 mg/m2 ,and then oxaliplatin 130 mg/m2 ;and the patients in the nedaplatin group were treated with paclitaxel injection 175 mg/m2, and then neclaplatin 80 mg/m2. All the four treatment were repeated every 21 days and lasted 4 cycles. The therapeutic effect and safety was evaluated after 2 weeks later chemotherapy. Results All patients were underwent successful 4 cycles chemotherapy. The response rate （CR ＋ PR） of the cisplatin group, carboplatin group,oxaliplatin group and nedaplatin group were 33.3% , 30.0%, 33.3% and 36.7%, respectivelY,there were no statistical difference among these groups （ P 〉 0.05 ）. As for the adverse reaction, there were significance in decrease of white blood cell and platelets （ P 〈 0.05 ）, while no statistical difference in pain of muscle and joint, nervous lesion, renal function lesion, nausea and vomiting （ P 〉 0. 05 ）. Conclusion There was similar therapeutic effect on NSCLS with paclitaxel injection plus cisplatin, paclitaxel, oxaliplatin and nedaplatin, and the oxaliplatin had less adverse response than others.