DP与GP方案治疗晚期非小细胞肺癌的临床观察

A clinical study of DP and GP in treating advanced non-small cell lung cancer(NSCLC)

目的:评价DP方案(多西他赛+顺铂)和GP方案(吉西他滨+顺铂)治疗晚期非小细胞肺癌(NSCLC)的疗效和不良反应。方法:DP方案治疗晚期NSCLC 38例,多西他赛(docetaxel)37.5mg/m2,静脉滴入,d1,8;顺铂(DDP)25mg/m2,静脉滴入,d1-3。GP方案治疗晚期NSCLC 42例,吉西他滨(gemcitabine)1000mg/m2,静脉滴入,d1,8;DDP用法同DP方案。每3周重复,2个周期化疗后评价疗效。结果:DP方案有效率为44.7%(17/38),其中腺癌50%(10/20),鳞癌37.5%(6/16);GP方案有效率38.1%(16/42),其中腺癌30%(6/20),鳞癌50%(10/20)。DP方案组中位生存期10.1个月,1年生存率47.2%;GP方案组中位生存期9.5个月,1年生存率45%。两方案相比无统计学差异(P>0.05)。骨髓抑制及消化道反应为主要不良反应,其中Ⅲ度、Ⅳ度血小板减少率分别为2.6%(1/38)和16.7%(7/42),差异有统计学意义(P<0.05)。结论:DP和GP方案治疗晚期NSCLC效果均有效,但DP方案对腺癌疗效比GP方案更有优势,GP方案对鳞癌更有优势。

Objective：To observe the therapeutic effects and toxic reactions of DP（docetaxel and cisplatin） and GP（gemcitabine and cisplatin） chemotherapy schemas for advanced non-small cell lung cancer.Methods：Thirty-eight patients were treated with DP chemotherapy used docetaxel（37.5mg/m2）on d1,8 and DDP（25mg/m2） on d1-3 respectively when 42 patients were treated with GP chemotherapy used gemcitabine（1000mg/m2） on d1,8 and DDP（25mg/m2） on d1-3.Each cycle was 3 weeks.The therapeutic effects were observed two cycles later.Results：The effective power（RR） of DP chemotherapy was 44.7%（17/38）.Among them RR of adenocarcinoma was 50%（10/20） and of squamous cell carcinoma 37.5%（6/16）,GP was 38.1%（16/42）.Among them the RR of adenocarcinoma was 30%（6/20） and of squamous cell carcinoma 50%（10/20）.For 38 patients treated with DP regimen,the median survival time was 10.1 months and 1-year survival rate 47.2%.For 42 patients treated with GP regimen,the median survival time was 9.5 months and the 1-year survival rate 45%.There was no difference between DP and GP regimens（P0.05）.The significant toxic reactions were myelosuppression and nausea,The rates of grade Ⅲ-Ⅳ thrombocytopenia were 2.6%（1/38）in DP regimen and 16.7%（7/42）in GP regimen respectively（P0.05）.Conclusion：There are marked effects for advanced stage of NSCLC treated with either DP or GP.The effects of DP on adenocarcinoma is better than of GP when the effects of GP on squamous cell carcinoma better than of DP.