多西他赛联合卡铂每周和三周方案治疗晚期非小细胞肺癌的临床观察

Weekly and three-weeks' docetaxel combined with carboplatin in patients with advanced non-small cell lung cancer

目的:对比观察多西他赛联合卡铂每周方案与三周方案治疗晚期非小细胞肺癌的临床疗效及不良反应。方法:84例晚期非小细胞肺癌患者分为两组,每周方案组(A组42例):多西他赛25mg/m2静脉滴注第1、8、15天,卡铂AUC=5静脉滴注第1天,每21天重复。三周方案组(B组42例):多西他赛75mg/m2静脉滴注第1天,卡铂AUC=5静脉滴注第1天,每21天重复。治疗2个周期评价疗效,每周期评价毒性。结果:所有患者均可评价疗效及不良反应。A组与B组的有效率分别为45.2%和42.9%,两组比较差异无统计学意义(P>0.05);中位TTP分别为5.4个月和5.3个月,两组比较差异无统计学意义(P>0.05);中位生存期分别为10.3个月和10.5个月,两组比较差异无统计学意义(P>0.05);Ⅲ/Ⅳ度中性粒细胞减少分别为16.7%和33.3%,两组比较差异有统计学意义(P<0.05);Ⅲ/Ⅳ度恶心呕吐分别为9.5%和16.7%,两组比较差异有统计学意义(P<0.05)。结论:多西他赛联合卡铂每周方案与三周方案相比,疗效近似,每周方案骨髓抑制及恶心呕吐明显下降,耐受性较好。

Objective：To compare the clinical efficacy and toxicity of weekly and three-weeks＇ docetaxel combined with carboplatin in patients with advanced non-small cell lung cancer.Methods： Total of 84 patients with advanced non-small cell lung cancer were divided into two groups：Group A,Docetaxel 25mg/m2 iv d1,8,15,carboplatin AUC=5 iv d1,q21 days;Group B,Docetaxel 75mg/m2 iv d1,carboplatin AUC=5 iv d1,q21 days.The clinical responses were assessed after two cycles.Toxicity was assessed every cycle.Results： All patients were assessable for response and toxicity.The total response rates in group A and B were 45.2% and 42.9%,respectively;The median time to progression（TTP） of group A and B were 5.4 months and 5.3 months,respectively;The median survival time（MST） of group A and B were 10.3 months and 10.5 months,respectively.Grade Ⅲ/Ⅳ neutropenia were 16.7% and 33.3% in group A and B;The major non-hematologic toxicity was nausea /vomiting.Grade Ⅲ/Ⅳ nausea /vomiting were 9.5% and 16.7% in group A and B.There was no significant difference of response rate,median time to progression and median survival time between these two groups（P0.05）.But there was significant difference of grade Ⅲ/Ⅳ neutropenia and grade Ⅲ/Ⅳ nausea/vomiting between these two groups（P0.05）.Conclusion： The clinical efficacy was similar between group A and B.But the occurrence of myelosuppression and nausea /vomiting were lower in weekly treatment group.