5-氟尿嘧啶超声雾化吸入联合MVP方案治疗Ⅲb-Ⅳ期非小细胞肺癌的临床观察

Clinical Observation of 5-fluorouracil Ultrasonic Atomizing Inhalation Combined with MVP Chemotherapy for Ⅲ_b-Ⅳ Stage Non-small Cell Lung Cancer

目的：观察5-氟尿嘧啶超声雾化吸入联合丝裂霉素、长春地辛、顺铂（MVP）方案治疗Ⅲb～Ⅳ期非小细胞肺癌（NSCLC）的疗效和安全性。方法：160例NSCLC患者按随机数字表法均分为5-氟尿嘧啶超声雾化吸入组（HTP组）,丝裂霉素、长春地辛、顺铂静脉化疗组（MVP组）,HTP联合MVP组（联合组）和5-氟尿嘧啶静脉化疗组（对照组）。HTP组患者给予5-氟尿嘧啶5 mg/kg＋α-糜蛋白酶10 mg加入0.9%氯化钠注射液中配成20 ml混合溶液,装入雾化器中雾化吸入0.5 h,bid,d1-3/周,治疗12周;MVP组患者给予丝裂霉素8 mg/m2,d1、d8静脉滴注,qd＋长春地辛2.5 mg/m2,d1、d8静脉滴注,qd＋顺铂30 mg/m2,d1-3静脉滴注,qd,28 d为1个周期,共3个周期;联合组患者给予HTP组＋MVP组方案联合治疗;对照组患者给予α-糜蛋白酶10 mg加入0.9%氯化钠注射液中配成20 ml混合溶液雾化吸入＋5-氟尿嘧啶5 mg/kg,静脉滴注,bid,d1-3/周,治疗12周。所有患者治疗12周后评价疗效。观察4组患者的总有效率、毒性反应及随访1年、2年的生存率。结果：联合组患者总有效率〉MVP组〉HTP组〉对照组,联合组患者1年、2年生存率〉MVP组〉HTP组〉对照组。

ABSTRACT OBJECTIVE： To observe of therapeutic efficacy and safety of 5-fluorouracil ultrasonic atomizing inhalation combined with mitomycin, vindesine and cisplatin （MVP） for Ⅲb～Ⅳ stage non-small cell lung caner （NSCLC）. METHODS： 160 cases of NSCLC were divided randomly into 5-fluorouracil ultrasonic atomizing inhalation group （HTP group） , MVP group, HTP combined with MVP treatment group （combination group） and 5-fluorouracil chemotherapy group （control group）. HTP group was given 5-fluorouracil 5 mg/kg＋20 ml mixture of-chymotrypsin 10 mg and 0.9% Sodium chloride injection put into atomizer for half hour atomizing inhalation, bid, 3 days a week, for 12 weeks. MVP group was given intravenous dripping of mitomycin 8 mg/m2 and vindesine 2.5 mg/m2, on dl and d8, qd; cisplatin 30 mg/m2, on d1-3, qd; 28 days were regarded as a treatment cycle, and the groups received 3 cycles of treatment. Combination group received regimen of HTP group combined with MVP group. Control group was given 20 ml mixture of-chymotrypsin 10 mg and 0.9% Sodium chloride injection for atomizing inhalation＋ 5-fluoroura- cil 5 mg/kg intravenously, bid, 3 days a week, for 12 weeks. Therapeutic efficacies of those groups were evaluated after 12 weeks of treatment. Toxic reactions of 4 groups were observed and 1-year and 2-year survival rate were followed up. RESULTS ： Total effective rate was in descending order： combination group〉MVP group〉HTP group〉control group. 1-year and 2-year survival rate was in descending order： combination group〉MVP group〉HTP group〉control group; there was statistical significance. The case number of toxic reaction was in ascending order： control group〈combination group〈MVP group〈HTP group; there was statistical significance. CONCLUSIONS： 5-fluorouracil ultrasonic atomizing inhalation combined with MVP chemotherapy for Ⅲb～Ⅳ stage NSCLC is safer and more effective than MVP or HTP chemotherapy alone. It can significantly improve the survival rate of patients with good condition.