回顾性分析奈达铂在术后2期非小细胞肺癌化疗中的作用

Retrospective analysis of the effect of Nedaplatin in postoperative chemotherapy of non-small cell lung cancer stage 2

目的研究奈达铂在术后2期非小细胞肺癌患者化疗中的作用。方法回顾性分析283名术后2期非小细胞肺癌患者术后化疗的临床资料。将患者分为奈达铂组和顺铂组。收集3级-4级的副反应资料、总生存率和无进展生存率。以Kaplan-Meier法进行生存分析。结果大多数患者病理类型为腺癌患者及非吸烟患者。在奈达铂组中,白细胞降低率、中性粒细胞降低率、血小板的降低率分别为27.0%、19.0%、10.3%,较顺铂组显著性降低,差异均有统计学意义（P〈0.05）。2组的总生存率和无进展生存率差异无统计学意义（P〉0.05）。多因素风险比例回归分析显示,尽管奈达铂可降低总的死亡风险（风险比例为0.975;95%CI：0.730-1.302;P=0.864）和提高无进展死亡风险（风险比例为1.084;95%CI：0.811-1.448;P=0.585）,但差异无统计学意义。结论奈达铂的副作用明显低于顺铂。奈达铂在术后2期非小细胞肺癌化疗中的作用与顺铂相当,有望成为化疗药物。

Objective To evaluate the effectiveness of Nedaplatin in postoperative chemotherapy of NCSLC stage 2. Methods The clinical data of 283 cases of stage 2 NCSLC patients were retrospectively analyzed in postoperative chemotherapy. They were categorized into two groups： nedaplatin plus gemcitab（ NG） and cisplatin plus gemcitab（ CG）. The side effect data of level 3 or 4,overall survival（ OS） and progression-free survival（ PFS） were collected. Survival analysis was conducted with Kaplan-Meier method. Results The majoritypathological types were adenocarcinoma patients and non smoking patients. In the NG group,the reduction rates of white blood cell,neutrophil and platelet were 27. 0%,19. 0%,10. 3%,significantly lower than CG group,the differences were statistically significant（ P〈0. 05）. There was no statistical significance on the difference of the overall survival rate and un-developing survival rate between the 2 groups（ P〉0. 05）. In multivariate analysis,although nedaplatin decreased the risk of the total mortality（ Risk ratio was 0. 975; 95% CI： 0. 730-1. 302; P = 0. 864） and increased the risk of the un-developing mortality（ Risk ratio was 1. 084; 95% CI： 0. 811-1. 448; P = 0. 585）,but no significant difference was found. Conclusion The side effects of nedaplatin were slighter than cisplatin. Nedaplatin was able to provide similar effect as cisplatin in postoperative chemotherapy for stage 2 NSCLC. Nedaplatin was a promising chemotherapeutic agent for NSCLC.