去甲长春花碱、异环磷酰胺和顺铂动静脉给药治疗46例非小细胞肺癌的疗效观察

Chemotherapy with Navelbine,Ifosfamide and Cisplatin for 46 Cases of NSCLC by Intraartery and Intravenous Infusion

目的 观察去甲长春花碱 (NVB)、异环磷酰胺 (IFO )和大剂量顺铂 (DDP )联合动、静脉给药治疗晚期非小细胞肺癌(NSCLC)的疗效及不良反应。方法 46例NSCLC随机分为供瘤动脉给药组 (A组 )和静脉给药组 (B组 )。A组 :2 6例 ,NVB 30mg/m2 ,DDP 80mg/m2 ,供瘤支气管动脉灌注 ,第 1天 ;B组 :2 0例 ,NVB 30mg/m2 ,DDP 80mg/m2 ,静脉点滴 ,第 1天。 2组均用IFO 2 .0 g ,静脉点滴 ,连用 3天。 2 8天为 1个周期 ,至少治疗 2个周期。 结果 CR 0例 ,PR 32例 ,总有效率 6 9.6 %。A组有效率为 73 .1% (19/2 6 ) ,B组有效率为 6 5 .0 % (13/2 0 )。毒副作用主要为骨髓抑制 ,白细胞减少发生率达 10 0 .0 % ,其中Ⅲ度、Ⅳ度发生率为 6 3 .0 % ,A组为 5 7.7% (15 /2 6 ) ,B组为 70 .0 % (14 /2 0 )。静脉注射局部毒性发生率为 35 .0 % (7/2 0 )。结论 NVB、IFO和DDP联合治疗晚期NSCLC的有效率高 ,供瘤支气管动脉给药优于静脉给药 ,毒性可耐受。

Objective To evaluate the results and toxicity of combination chemotherapy with navelbine(NVB),ifosfamide(IFO) and cisplatin(DDP) for NSCLC by intraartery and intravenous infusion.Methods 46 patients with advanced NSCLC were enrolled.Group A(26 patients) was given by intraartery infusion(IA) chemotherapy consisting of NVB 30 mg/m2 and DDP 80 mg/m2 on day 1.Group B(20 patients) was given by intravenous infusion(IV) chemotherapy consisting of NVB 30 mg/m2 and DDP 80 mg/m2 on day 1.Both groups were given IFO 2.0 g for three days by Ⅳ.At least two therapeutic courses were given each with an interval of 28 days.Results Partial response(PR) was observed in 32 patients.The response rate was 69.6% in overall,73.1% in group A,65.0% in group B.The main toxicity was myelosuppression.Neutropenia was found in all treated cases,among them,grade Ⅲ and Ⅳ accounted for 63.0%(57.7% in group A,70.0% in group B).The local venous toxicity was observed in 35.0% of group B.Conclusion A high response rate was obtained in advanced NSCLC treated by NVB,IFO and DDP with tolerable toxicity and the response rate in the patients treated by IA may be higher than those treated by Ⅳ.