三药联合化疗方案治疗晚期非小细胞肺癌伴神经内分泌分化的疗效观察

Effect of Three-drug Combination Chemotherapy in Advanced Non-small Cell Lung Carcinoma with Neuroendocrine Differentiation Treatment

目的观察三药联合化疗方案治疗晚期非小细胞肺癌伴神经内分泌分化的近期疗效、远期疗效和不良反应：方法39例未经治疗的晚期非小细胞肺癌伴神经内分泌分化（NSCLC-ND）患者中，194例接受紫杉醇＋顺铂＋依托泊苷（E．TP）三药联合方案，20例接受紫杉醇＋顺铂（TP组）两药化疗方案，比较两种化疗方案的近期疗效、远期疗效及不良反应。结果E-TP组有效率明显高于TP组（47．4％vs．15．0％，P〈0．05），疾病控制率E-TP组也明显高于TP组（94．7％vs70．0％，P〈0．05）。E-TP组中位无病生存期较TP组长（P〈0．05）。粒细胞减少E-TP组发生率明显高于TP组（P〈0．05），其中Ⅲ～Ⅳ度粒细胞减少的发生率高于TP组（P〈0．05）。结论三药联合方案化疗对晚期非小细胞肺癌伴神经内分泌分化的疗效明显优于TP组，不良反应可耐受。

Objective To observe the short-term efficacy, long-term efficacy and adverse reactions of the three-drug combination chemotherapy in the treatment of the advanced non-small cell lung carcinoma with neuroendocrine differentiation（NSCLC-ND）. Methods Nineteen patients with NSCLC-ND were treated with three-drug combination of etoposide,paclitaxel and cisplatin chemotherapy （E-TP group） and twenty patients were treated with two-drug combination ofpaclitaxel and cisplatin chemotherapy （TP group）. Short-term efficacy, long-term efficacy and adverse reaction of two chemotherapies were compared. Results The efficiency of E-TP group was significantly higher than that of TP group（47.4% vs. 15.0%, P〈0.05）. The disease control rate of E-TP group was apparently higher than that of TP group（94.7% vs. 70.0%, P〈0.05）. The median disease free survival of E-TP group was longer than that of TP group（P〈0.05）. The neutropenia incidence of E-TP group was significantly higher than that of TP group, especially in the III-IV degree（P〈0.05）. Conclusion The three- drug combination chemotherapy had higher efficacy than TP combination in the treatment of advanced non- small cell lung carcinoma with neuroendocrine differentiation, and the adverse reactions could be tolerated. The three-drug combination chemotherapy could be further promoted.