厄洛替尼联合多烯紫杉醇-卡铂治疗晚期非小细胞肺癌的临床研究

Clinical Study of Erlotinib Combined with Docetaxel-carboplatin in the Treatment of Advanced Non-small Cell Lung Cancer

目的:探讨厄洛替尼联合多烯紫杉醇和卡铂对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效及毒副反应。方法:选择2010年1月-2012年1月我院收治的Ⅲb或Ⅳ期非鳞状非小细胞肺癌患者共92例。所有病例均给予多烯紫杉醇(100mg/m3)+卡铂(AUC 5.5,浓度-时间曲线下面积5.5)治疗2个周期,完成2个周期治疗后,将病人随机分为对照治疗组(多烯紫杉醇+卡铂治疗)和厄洛替尼治疗组(厄洛替尼联合多烯紫杉醇+卡铂治疗),每组各46例,厄洛替尼组给予口服厄洛替尼150mg/dl/天剂量治疗。两组均继续治疗2个周期,观察厄洛替尼联合多烯紫杉醇-卡铂治疗对晚期非小细胞肺癌患者的疗效、患者中位生存期及毒副反应。结果:两组患者治疗客观有效率对照治疗组为26.1%,厄洛替尼治疗组为45.6%,差异具有统计学意义(P<0.05)。厄洛替尼治疗组患者中位生存期为6.9个月。与对照治疗组相比,厄洛替尼治疗组中患者3/4级中性粒细胞降低的发生率显著降低,差异具有统计学意义(P<0.05)。结论:厄洛替尼能增强多烯紫杉醇+卡铂治疗方案对晚期非小细胞肺癌的疗效,减轻化疗的毒副反应。

Objective： To investigate the efficacy and toxicity of erlotinib combined with docetaxel-carboplatin on advanced non-small cell lung cancer patients. Methods： A total of 92 initially treated patients with Ⅲb or Ⅳ non-small cell lung cancer （NSCLC） were enrolled in this study. All the patients were treated with two cycles of carboplatin （area under the concentration-time curve 5.5） and docetaxel 100 mg/m^3. After completion of two treatment cycles, patients were randomly divided into two groups： 46 continued previous chemotherapy （control group） until disease progression, 46 received previous chemotherapy plus erlotinib 150 mg daily until disease progression; both for another two cycles. Then observe the curative effect, median survival and toxicity of erlotinib combined with paclitaxel carboplatin therapy for advanced non small cell lung cancer patients. Results： Compared with control group （26.1%）, the objective response rate of erlotinib group （45.6%） was increased significantly （P〈0.05）. Median survival duration was 6.9 months for erlotinib group. Compared with control group, the incidence of grade 3 and 4 neutrophile granulocyte significantly decreased in erlotinib group （P〈0.05）. Conclusion： Erlotinib combined with docetaxel-carboplatin treatment could enhance the efficacy on advanced non-small cell lung cancer and reduce toxicity of chemotherapy.