含长春瑞滨系列联合方案治疗50例晚期非小细胞肺癌

VINORELBINE CONBINED WITH OTHER ANTICANCER DRUGS IN THE MANAGEMENT OF 50 ADVANCED PATIENTS WITH NON SMALL CELL LUNG CANCER

目的研究在长春瑞滨（Ｖｉｎｏｒｅｌｂｉｎｅ，ＮＶＢ）加顺铂（Ｃｉｓｐｌａｔｉｎ，ＤＤＰ）方案基础上进一步针对病理学分类和癌细胞分化程度的系列联合化疗方案治疗非小细胞肺癌（ｎｏｎｓｍａｌｃｅｌｌｕｎｇｃａｎｃｅｒ，ＮＳＣＬＣ）的疗效。方法低、中分化程度的肺鳞癌和低分化肺腺癌仍采用基础方案即ＮＶＢ＋ＤＤＰ方案治疗，高分化肺鳞癌在基础方案之上加用博莱霉素（ＢＬＭ），中、高分化肺腺癌在基础方案之上加用多柔比星（阿霉素，ＡＤＭ）。５０例ＮＳＣＬＣ中，男性２７例，女性２３例。腺癌３０例，低、中、高分化程度分别为１３、１１和６例；鳞癌１６例，低、中、高分化程度分别为５、６和５例；混合型病理诊断３例，均为低分化程度。Ⅲｂ期３２例，Ⅳ期１８例。结果完全缓解（ＣＲ）４例，部分缓解（ＰＲ）２９例，稳定（Ｓ）１３例，进展（Ｐ）４例，总有效率为６６％。中位缓解期３９月，ＫａｐｌａｎＭｅｉｅｒ估计半数死亡概率为１２个月。系列方案的剂量限制性毒性为骨髓抑制，发生率为１００％，注药局部反应发生率为４８％。结论ＮＶＢ抗非小细胞肺癌治疗疗效确切，在ＮＶＢ＋ＤＤＰ联合化疗方案中适当增加抗癌药物品种似可增加疗效。

PURPOSE To observe further the efficacy of vinorelbine(navelbine) in the treatment of non small cell lung cancer(NSCLC) with a series of schemes in combination with other anticancer drugs which were used as based on pathological classification and cancer cell atypia. METHODS Vinorelbine (NVB)+cisplatin (DDP) were used in the treatment of patients with moderate or loady differentiated squameous or(and)undiferentiated adenocarcima as a basic combination chemotherapy scheme, and NVB+DDP+bleomycin(BLM) in the patients with highly differentiated squamous carcinoma NVB+DDP+doxorubicin(ADM) in moderately and hihgly differentiated adenocarcinoma. 50 cases were treated,with 27 cases male and 23 female. Of these 30 patients lung adenocarcinomas,16 were squamous,4 others unknown. Staging:Ⅲb 32 cases,Ⅳ 18 cases. RESULTS Among the 50 patients treated there are 4 CR,29 PR,13 NC and 4 PD, with a total effective rate of 66%. The median time of remission was 3.9 months.The probability value of half lethal time was 12 months following anticancer drug withdrawal.The main ADRs of combined chemotherapy were bone marrow suppression which took place in all of patients.There were 48% of cases with phlebitis. CONCLUSION The efficacy of navelbine in the treatment of advanced non small cell lung cancer is comparable with those previously reported;while the role of DDP+NVB combined with ADM/BLM is worthy of further observation.