化疗剂量强度对肺癌患者近期疗效的影响

Effect of Chemotherapy Dose Intensity on the Short-term Efficacy of Patients with Lung Cancer

目的探讨不同化疗剂量强度对肺癌患者近期疗效以及不良反应的影响。方法临床纳入Ⅲb~Ⅳ期非小细胞肺癌患者396例,所有患者均采用多西他赛单药方案二线化疗。采用实体瘤化疗疗效对治疗效果进行评价,同时观察各化疗剂量强度引发肺癌患者不良反应情况。结果根据患者化疗的相对剂量强度,分为低剂量组（〈0.65）,中剂量组（0.66~0.74）,高剂量组（≥0.75）。其中,高剂量组治疗有效率为69.52%,中剂量组治疗有效率为57.44%,低剂量组治疗有效率为40.63%。高剂量组临床治疗有效率明显高于低剂量组、中剂量组,差异有显著性（P〈0.05）;化疗期间主要不良反应为白细胞、血小板及红细胞数目下降,胆红素水平升高,转氨酶升高,腹泻、腹痛、恶心、呕吐等胃肠道反应。化疗期间不良反应发生率高剂量组为45.71%,中剂量组为28.72%,低剂量组为25.00%;高剂量组不良反应发生率明显高于低剂量组、中剂量组,差异有显著性（P〈0.05）;化疗后随访3年发现,高剂量组1、2、3年生存率分别为82.86%、60.95%、28.57%,中剂量组1、2、3年生存率分别为81.03%、46.15%、16.41%,低剂量组1、2、3年生存率分别为79.17%、38.54%、11.46%。高剂量组1年生存率与低剂量组、中剂量组比较无差异（P〉0.05）,而2年、3年生存率高剂量组明显高于低剂量组、中剂量组（P〈0.05）。结论高剂量强度的化疗药物,能够有效提高肺癌患者近期疗效。但其临床不良反应发生率亦较高。因此,对肺癌患者进行化疗剂量的选择时,需要根据患者的实际情况进行考虑。同时,还需要密切监测患者的各项不良反应。

Objective To investigate the effect of chemotherapy dose intensity on the short-term efficacy and adverse reactions of patients with lung cancer.Methods 396 cases of patients with stage IIIb ~ IV non-small cell lung cancer were were given docetaxel chemotherapy as second-line chemotherapy.The curative effect of tumor chemotherapy entity was used to evaluate treatment effect,and observe the dose intensity of chemotherapy induced adverse reactions in patients with lung cancer.Results According to the relative dose intensity of chemotherapy in patients,they were divided into low dose group（P〈0.65）,medium dose group（0.66 ~ 0.74）,and high dosage group（≥0.75）.The effective rate of high dose treatment group was 69.52%,the effective rate of medium dose treatment group was 57.44%,the effective rate of low dose treatment group was 40.63%.Clinical effective rate of high dose group was significantly higher than that of low dose group,and middle dose group,the difference was significant（P〈0.05）; The main adverse reactions during chemotherapy were leukopenia,thrombocytopenia and erythropenia,elevated bilirubin,elevated transaminases,diarrhea,abdominal pain,nausea,vomiting and other gastrointestinal reactions.Adverse reactions rate during chemotherapy of high dose group was 45.71%,the middle dose group was 28.72%,the low dose group was25.00%; adverse reactions rate in the high dose group was significantly higher than those of low dose group and middle dose group,the difference was significant（P〈0.05）; 3-year follow-up found that 1-,2-,3-year survival rates in high dose group were82.86%,60.95%,28.57%,middle dose group were 81.03%,46.15%,16.41%,low dose group were 79.17%,38.54%,11.46%.1-year survival rate of the 3 groups had no significant difference（P〈0.05）,2-,3-year survival rates in high dose group were significantly higher than those of low dose group and middle dose group（P〈0.05）.Conclusion High dose intensity of chemotherapy drug can effectively improve short-term efficacy of lung cancer patients.However,the incidence of clinical adverse reactions is also high.Therefore,chemotherapy dose for lung cancer patients need to consider the actual situation of patients.And various adverse reactions should be closely monitored.