吉西他滨联合异环磷酰胺二线治疗晚期非小细胞肺癌疗效分析

Gemcitabine combined with ifosfamide as second-line chemotherapy in advanced non-small cell lung cancer

为了观察吉西他滨联合异环磷酰胺方案二线治疗晚期非小细胞肺癌(NSCLC)的疗效及不良反应,选取24例病理或细胞学确诊的晚期NSCLC,经紫杉类联合铂类化疗方案治疗进展的患者,采用吉西他滨1.0 g/m2,静脉滴入,d1、d8;异环磷酰胺1.2 g/m2,静脉滴入,d2～d4,21 d为1个周期,以TAX317研究结果为历史对照,进行统计分析。可评价疗效24例中,无完全缓解(CR)病例,部分缓解(PR)5例,稳定(SD)12例,进展(PD)7例,有效率21%(5/24),优于TAX317的疗效(6%),化疗不良反应主要是骨髓抑制,3/4度中性粒细胞减少及贫血发生率分别为17%(4/24)及13%(3/24)。初步研究结论提示,吉西他滨联合异环磷酰胺二线治疗晚期NSCLC临床有效,耐受良好,可开展进一步随机对照研究。

The objective of this study was to evaluate the effectiveness and side effects of gemcitabine combined with ifosfamide as the second-line treatment in patients with advanced non-small cell lung cancer （NSCLC）. Twenty four patients with histologically or cytologically confirmed advanced NSCLC were treated with gemcitabine （GEM） 1.0 g/m^2 , d1 ,d8, and ifosfamide（IFO） 1.2 g/m^2 , d2 -d4 （with mesna） ,iv. drip every 3 weeks. Treatment outcomes were compared with a histori cal control of results TAX317. All patients had received prior taxane nplatinum-based regimens. Five of 24 assessable patients achieved partial response （PR）, 12 stable disease （SD）, 7 progressive disease （PD）, and there was no complete response （CR）. The response rate （RR 21%） was significantly better than TAX317 （RR 6%）. Myelosuppression was the main side-effect with（WHO） grade 3/4 neutropenia and anemia in 17 % （4/24） and 13 % （3/24） of the patients, respectively. In conclusion,GEM combined with IFO is an effective regimen with tolerable toxicity in the second-line treatment of NSCLC. The randomized trial can he carried out in the future.