米托蒽醌联合化疗治疗晚期非小细胞肺癌的近期疗效和毒性

A COMPARISON OF THE THERAPEUTIC EFFECTS WITH MITOXANTRONE CONTAINING REGIMENS FOR TREATMENT OF ADVANCED NON SMALL LUNG CANCER

目的:观察米托蒽醌为主的联合化疗方案治疗晚期非小细胞肺癌的近期疗效及安全性。方法:74例经病理确诊的b-期非小细胞肺癌患者非随机分成三组,CMP方案治疗21例,IMP方案治疗25例,并与CAP方案治疗28例比较。结果:CMP、IMP及CAP方案总的缓解率分别为28.6%、44%及32.1%。三方案对鳞癌的缓解率分别为33.3%、53.8%及37.5%;对腺癌的缓解率分别为22.2%、33.3%及25%。在统计学上,CMP、IMP与CAP之间其缓解率无显著性差异(P>0.05),各组间鳞癌与腺癌的缓解率无显著性差异(P>0.05)。三组的心脏毒性均不明显;CMP与CAP之间其骨髓毒性、消化道毒性、脱发等相似(P>0.05);IMP及CAP之间其消化道毒性相似(P>0.05),WBC↓率与脱发有显著性差异(P<0.05),～WBC↓率与PLT↓率有显著性差异(P<0.005)。结论:米托蒽醌为主的联合化疗方案为治疗晚期非小细胞肺癌较有效的方案。IMP方案其骨髓毒性较大。

OBJECTIVE: To evaluate the activity and safety of CMP(CTX+MTZ+DDP) regimen and IMP(IFO+MTZ+DDP) regimen on advanced non small cell lung cancer (NSCLC).METHODS:74 cases of histologically proven advanced NSCLC were unrandomly divided into three groups,of whom 21 cases were treated with CMP regimen, 25 cases with IMP regimen, 28 cases with CAP (CTX+ADM+DDP) regimen(contrast group).RESULTS:The result showed that response rates (RR) of CMP regimen and IMP regimen and CAP regimen were 28.6%,44% and 32.1%, that RR of squamous canrinoma in CMP/IMP/CAP were 33.3%,53.8% and 37.5%, that RR of adenocarcinoma in CMP/IMP/CAP were 22.2%,33.3% and 25%. There were no significant differences in RR among them and between squamous carcinoma and adenocarrinoma respectively (P>0.05). The cardiac toxicity were low in them. There was no significant difference in Myelosuppression and gastrointestinal tract reaction and alepecia between CMP regimen and CAP regimen (P>0.05). There was no significant difference in gastrointestinal tract reaction between IMP regimen and CAP regimen (P>0.05). neutropenia and alepecia had significant differences between IMP regimen and CAP regimen (P<0.05). Ⅲ Ⅳgrade of neutropenia and thrombocytopenia had very significant differences between IMP regimen and CAP regimen (P<0.005).CONCLUSION:These data showed Mitoxantrone combined chemotherapy were favorable in treatment of advanced NSCLC. IMP regimen myelosuppression was severe, So use of IMP regimen should be careful.