吉西他滨与多西他赛联合卡铂治疗晚期非小细胞肺癌的疗效观察

The clinical observation of gemcitabine or docetaxel combined with carboplatin in the treatment of non small cell lung cancer

目的评价吉西他滨与多西他赛联合卡铂方案治疗晚期非小细胞肺癌(NSCLC)的疗效及毒副反应。方法经病理组织学或细胞学证实的400例晚期NSCLC患者,随机分为两组,吉西他滨联合卡铂组(A组)200例,以吉西他滨1000mg/m2静滴,第1、8d,卡铂AUC5mg,第1d;多西他赛联合卡铂组(B组)200例,以多西他赛75mg/m2静滴,第1d,卡铂AUC5mg,第1d,两方案均每3周重复,完成4周期化疗后进行疗效评价。结果A组193例、B组182例完成4期化疗后进入评价,A、B两组的有效率分别为40.93%与33.52%,组间无显著性差异(P>0.05)。B组血小板下降、恶心、呕吐、腹胀、便秘、发热、肾功能损伤及周围神经麻痹发生率较A组高(P<0.05)。结论吉西他滨和多西他赛联合卡铂两组在治疗有效率方面较接近,但多西他赛联合卡铂毒副反应更大。

Objective To estimate the clinical effectiveness and side effects of the two protochols ,carbomatin combined gemcitabine or docetaxel, in the treatment of advanced non small cell lung cancer （NSCLC） patients. Meth ods 400 patients with advanced NSCLC confirmed by histology or cellology were divided into two groups at random. In group A,200 patients were treated with gemcitabine 1000 mg/m^2 ivgtt on dl and d8, and carboplatin 5mg ivgtt on dl.In group B,200 patients were treated with docetaxel 75mg/m^2 ivgtt on dl, and carboplatin 5mg ivgtt on dl.The treatment schedule was recycled every 3 weeks and the chemotherapy effect was evaluated after 4 cycles. Results 193 patients in group A and 185 patients in group B successfully achieved chemotherapy plan, and taken into evaluation. The effective rates of group A and B were 40.93% and 33.52% respectively.No significant difference was observed （P〉0.05）, In group B, the rates of thrombocytopenia, vomiting, nausea, abdominal tension, constipation, fever, renal function damage and peripheral neuropathy were obviously higher than group A （P〈0.05）. Conclusion There is no significant difference of Clinical effectiveness between the two regiments . But the combination of docetaxel and carboplatin has higher side reaction rate.