多西他赛联合奥沙利铂、联合顺铂对晚期非小细胞肺癌化疗的临床研究

Clinical effects of Docetaxel combined Cisplatin and Oxalipliatin on chemotherapy patients with advanced non-small cell lung cancer

目的观察多西他赛联合奥沙利铂方案与多西他赛联合顺铂方案对晚期非小细胞肺癌化疗的近期疗效以及毒副作用。方法晚期非小细胞肺癌者84例,随机分为两组。两组的多西他赛剂量均75g/m^2静脉滴注,治疗组奥沙利铂135 mg/m^2静脉滴注,每21 d重复;对照组顺铂75 mg/m^2分3 d静脉滴注(第1、2、3天),每21 d重复,连续化疗4周期,化疗后4周评价疗效及比较毒副作用。结果治疗组完全缓解5例,部分缓解16例,稳定18例,进展6例,有效率为46.7%。对照组完全缓解3例,部分缓解14例,稳定18例,进展4例,有效率为43.6%。治疗组有效率高于对照组,但差异无统计学意义(P>0.05)。治疗组与对照组1年生存率分别为31.1%、30.8%(P>0.05)。治疗组与对照组的有效率分别为51.1%、46.1%,差异无统计学意义(P>0.05)。治疗组OS(8.7±4.7)个月,95%IC(7.3～10.3)个月,对照组OS(8.5±4.9)个月,95%IC(6.9～10.1)个月,差异没有统计学意义(P=0.71)。治疗组的神经毒性较对照组明显(P<0.05),对照组血液学毒性、消化道反应和肝肾毒性较治疗组明显(P<0.05)。结论多西他赛联合奥沙利铂作为晚期非小细胞肺癌化疗方案与多西他赛联合顺铂方案比较近期疗效相当,血液学毒性、胃肠道反应和肝肾毒性明显较轻,生活质量较好,神经毒性可以接受,可以替代多西他赛联合顺铂作为NSCLC的一线化疗方案。

Objective To study the short term efficacy and side effects of Docetaxel combined with Oxaliplatin and Docetaxel combined with Cisplatin on patients with advanced non-small cell lung cancer （NSCLC）.Methods Patients with NSCLC were randomly divided into two groups：Docetaxel combined with Oxaliplatin as treatment group and Docetaxel combined with Cisplatin as control group. Docetaxel 75 mg/m^2 and Oxaliplatin 135 mg/m^2 were injected intravenously and the injection of Oxaliplatin was repeated every 21 d.Cisplatin 75 mg/m^2 were injected in three days（1,2 and 3 d） and repeated every 21 d.Curative effects and side effects were compared after 4 weeks.Results In treatment group,there were 5 patients having complete response（CR）,16 patients partial response （PR）,18 patients stable disease（SD）,6 patients progressive disease（PD） and the overall response rates was 51.1%.In control group,there were 3 patients having CR,14 patients PR,18 patients SD,4 patients PD,the overall response rate was 46.1%.One-year survival rates were 31.1%in treatment group and 30.1%in control group（P0.05）.The mean overall survival time（mOST） were（8.7±4.7） month,95%IC were 7.3 -10.3 month in treatment group and（8.5±4.9）month,95%IC were 6.9-10.1 month in control group,there were no significantly difference（P =0.71）.The neural toxicity in treatment group was lower than that in control group（P0.05）.The liver and renal function lesions, nausea,vomiting and the side effects of blood in treatment group were significantly lower than those in control group（P0.05）.Conclusion The effectiveness of Docetaxel plus Oxaliplatin and Docetaxel plus Cisplatin are similar,but the Docetaxel plus Oxaliplatin have lower emesis,nausea,liver and renal toxicity,which can take the place of Docetaxel plus Cisplatin as the first line of chemotherapy.