对症治疗与联合化疗治疗晚期非小细胞肺癌

Symptomatic treatment versus combination chemotherapy in advanced non small cell lung cancer

目的评价联合化疗对晚期非小细胞肺癌（ＮＳＣＬＣ）患者生存期的影响。方法７０例晚期非小细胞肺癌患者配对分组：３５例拒绝化疗者，接受对症治疗（对症组）。３５例接受联合化疗，丝裂霉素８～１０ｍｇ／ｍ２，第１天；顺铂２０ｍｇ／ｍ２，第１～５天；长春酰胺３ｍｇ／ｍ２，第１，８天；每４周重复。２～４周期后，口服喃呋啶２００～３００ｍｇ，每天３次，至肿瘤复发或进展止。结果中位生存期化疗组为９个月，对症组为４．５个月。１年生存率分别为３４．３％和８．０％。两组生存期差异有显著性（Ｐ＜０．００５，０．０１）。化疗的毒副反应主要是胃肠道反应和骨髓抑制。结论联合化疗可延长晚期非小细胞肺癌患者的生存期。

Objective To evaluate the effects on survival of combination chemotherapy in patients with advanced non small cell lung cancer (NSCLC). Methods Seventy patients with advanced NSCLC were pairingly divided into two equal groups: 35 patients who refused chemotherapy received symptomatic treatment; the other 35 patients received combined chemotherapy with mitomycin(8～10 mg/m 2, dl), vindesine (3 mg/m 2, dl, 8) cisplatin (20 mg/m 2, dl 5), repeated every four weeks for 2～4 cycles and followed by oral administration of Ftorafur (FT 207) 200～300 mg tid, until recurrence or progression of disease. Results The overall median survival time in the chemotherapy group was 9 months, and 4.5 months in the symptomatically treated group. The one year survival rate was 34.3% and 8.0% respectively. The major toxic effects of chemotherapy were gastrointerstinal tract reactions and myelosuppression. Conclusion Combination chemotherapy can prolong survival time in patients with advanced NSCLC.