吉西他滨联合顺铂一线治疗对Ⅲb～Ⅳ期肺鳞癌的疗效评价

Gemcitabine plus cisplatin as first-line therapy in treatment of stage Ⅲb ～ Ⅳ squamous cell lung carcinoma

目的探讨吉西他滨联合顺铂一线治疗对Ⅲb～Ⅳ期肺鳞癌的疗效,为临床用药提供一定的指导意义。方法选择Ⅲb～Ⅳ期非小细胞肺鳞癌患者43例,采用吉西他滨联合顺铂化疗方案治疗,以21天为1周期,治疗2-6周期,观察患者近期疗效、生活质量、营养状况,随访1、2年生存情况、PFS及治疗期间发生的不良反应。结果本组43例化疗结束后总有效率为48.8%;化疗后角色功能、情绪功能、躯体功能、整体生活质量量表（global quality of life,GQL）评分均高于化疗前,差异具有统计学意义（均P〈0.05）;而社会功能、认知功能评分与化疗前比较,差异不具有统计学意义（均P〉0.05）;化疗后体质指数、前清蛋白与血红蛋白与化疗前比较,差异无统计学意义（均P〉0.05）;化疗后血清清蛋白高于化疗前,差异具有统计学意义（P〈0.05）。本组43例化疗结束后1年生存19例（44.2%）,2年生存7例（16.3%）;PFS为3.8月。化疗期间以白细胞减少、血细胞减少及恶心、呕吐为主要不良反应,其发生率分别为65.1%、53.5%、46.5%。结论吉西他滨联合顺铂对Ⅲb～Ⅳ期肺鳞癌的疗效明显,可提高患者生活质量。

Objective To evaluate the clinical efficacy of gemcitabine combined with cisplatin as first-line therapy in treatment of stage Ⅲb ～ Ⅳ squamous cell lung carcinoma. Methods Forty-three patients with stage Ⅲb ～ Ⅳ squamous non-small-cell lung cancer were treated with gemcitabine combined with cisplatin. All patients received treatment for 2 ～ 6cycles with 21 d for a cycle. Patients were followed up for 1 to 2 years. Short-term efficacy,the quality of life,nutritional status,survival and the incidence of adverse events were observed. Results The overall response rate was 48. 8%. Scores in role function,emotional function,physical function,global quality of life（ GQL） were significantly higher after treatment（ all P 〈0. 05）,while there were no significant changes of scores in social function and cognitive function（ both P〉 0. 05）.There were no significant changes of body mass index and the levels of pre-albumin and hemoglobin before and after treatment（ all P〉 0. 05）,but albumin level was higher after treatment（ P〈 0. 05）. The 1-,2-year survival rates were44. 2%（ 19 /43） and 16. 3%（ 7 /43）,respectively. Major toxicities were leucopenia,erythropenia and nausea / vomiting during the treatment with incidence rates of 65. 1%,53. 5% and 46. 5%,respectively. Conclusion The efficacy of gemcitabine combined with cisplatin is generally satisfactory for patients with stage Ⅲb ～ Ⅳ squamous cell lung carcinoma.