紫杉醇脂质体联合卡铂一线治疗Ⅳ期肺腺癌近期疗效与安全性分析

Efficacy and Safety of Paclitaxel Liposomes with First-lined Carboplatin in the Treatment ofⅣ Stage Lung Adenocarcinoma

目的探讨应用紫杉醇脂质体联合卡铂一线治疗Ⅳ期肺腺癌近期疗效和安全性。方法对本院收治的61例病理诊断确诊为Ⅳ期肺腺癌患者随机分为紫杉醇脂质体联合卡铂一线组(治疗组)和紫杉醇联合卡铂一线组(对照组)。在每周给予卡铂一线治疗的基础上治疗组每周给予紫杉醇质体125 mg/m2,对照组给予紫杉醇125 mg/m2。每三周为一个周期,连续监测治疗两个周期后评价给药方案的有效率和疾病控制率,及血液学毒性和非血液学毒性。结果实验得到治疗组的有效率和疾病控制率分别为83.87%和93.55%,对照组的有效率和疾病控制率为53.33%和73.33%,治疗组均高于对照组。治疗组白细胞减少的概率、血红蛋白减少的概率、疲乏、肌肉关节痛和丙氨酸氨基转移酶升高率低于对照组,呕吐概率高于对照组。其他的血液学和非血液学毒性均无统计学差异(P<0.05)。结论紫杉醇脂质体联合卡铂一线治疗Ⅳ期肺腺癌的近期效果优于紫杉醇,临床上患者的毒副反应小,安全性高,适合临床推广。

Objective To explore the efficacy and safety of paclitaxel liposomes with first-lined carboplatin in the treatment ofⅣ stage lung adenocarcinoma.Methods 61 patients with advanced NSCLC were divided randomly into two groups.Treatment group was given paclitaxel liposome at 125 mg/m2 each cycle,and control group was given paclitaxel at125 mg/m2.Both groups combined with DDP at 75 mg/m2 per cycle every three weeks.The efficient rate and disease control rate、hematologic and non hematologic toxicity were evaluated after two cycles.Results The effective rate of treatment group was 83.87% and disease control rate was 93.55%,while the control group were 53.33% and 73.33%（P〈0.05）.Though there was no significant difference in hematological toxicity and most of non-hematological toxicity between the two groups,peripheral neuropathy and the toxicity from the mixed solvent of polyethoxylated castor oil and ethanol were significantly lower in treatment group than those in control group.Conclusion The short-term effect of paclitaxel liposome with first-lined carboplatin in the treatment ofⅣ stage lung adenocarcinoma is better than that of paclitaxel.It has less toxicity and side effects and higher safety,which is worth clinical promotion.