紫杉醇脂质体联合顺铂治疗中晚期肺鳞癌的疗效评价

Evaluation of curative effects of paclitaxel liposome combined with cisplatin in treatment of advanced pulmonary squamous cell carcinoma

目的比较紫杉醇脂质体联合顺铂与吉西他滨联合顺铂一线治疗中晚期肺鳞癌的临床疗效及毒副作用。方法62例Ⅲ/Ⅳ期肺鳞癌患者随机分为观察组和对照组,每组31例。观察组给予注射用紫杉醇脂质体175 mg/m2和顺铂75 mg/m2治疗,对照组给予注射用吉西他滨1000 mg/m2和顺铂75 mg/m2治疗,两组均是21 d为1个治疗周期,治疗2个周期后评价其临床疗效及毒副作用。结果治疗后两组肺部原发灶的治疗有效率及疾病控制率间均无明显差异(P>0.05),观察组区域转移淋巴结治疗有效率和疾病控制率分别为45.2%和90.3%,均显著高于对照组(P<0.05);观察组无进展生存期(PFS)为8.0个月,明显高于对照组的5.0个月(P<0.05);两组主要毒副反应均主要是血液学毒性和胃肠道反应,其中观察组血小板降低及胃肠道反应的发生率显著低于对照组(P<0.05)。结论紫杉醇脂质体联合顺铂治疗中晚期肺鳞癌疗效确切,毒副反应患者可耐受,对于伴有区域淋巴结转移的患者,该方案可获得更高的无进展生存期。

Objective To compare the curative effects and adverse reaction of paclitaxel liposome combined with cisplatin and that of gemcitabine combined with cisplatin as the preferred method in treatment of advanced pulmonary squamous cell carcinoma.Methods Total 62 patients with stage Ⅲ / Ⅳ pulmonary squamous cell carcinoma were randomly divided into the observation group and control group（ n = 31,respectively）. The observation group was administered with Paclitaxel liposome（ 175 mg / m^2） and cisplatin（ 75 mg/m^2） for injection,and the control group was administered with gemcitabine（ 1000 mg/m^2） and cisplatin（ 75 mg/m^2） for injection. For both groups,the course of treatment was 21 days. After two weeks of treatment,the curative effects and adverse reaction were evaluated. Results After the treatment,there were no significant differences in the treatment effectivenesss of pulmonary primary focus and control rate of disease between the two groups（ P〈 0. 05）; the treatment effectivenesss of regional lymph node metastasis and control rate of disease of the observation group were 45. 2% and 90. 3%,respectively,which were significantly higher than those in the control group（ P〉 0. 05）; the progression-free survival period（ PFS） in observation group was eight months,significantly longer than that in the control group of five months（ P〈 0. 05）. In both groups,the main adverse reactions include hematological toxicity and gastrointestinal reaction,in which the occurrence rates of decreased platelet counts and gastrointestinal reaction in the observation group were significantly lower than those in the control group（ P〈 0. 05）. Conclusion Paclitaxel liposome combined with cisplatin has definite curative effects on advanced pulmonary squamous cell carcinoma,and the adverse reaction can be tolerated by the patients. For the patients accompanied with regional lymph node metastasis,the scheme can obtain higher progression-free survival.