替吉奥联合奈达铂二线或多线治疗晚期非小细胞肺癌的临床效果研究

Clinical Effect of S-1 Combined With Nedaplatin as Second-line or Further-line Chemotherapy in the Treatment of Advanced Non-small-cell Lung Cancer

目的探讨替吉奥联合奈达铂二线或多线治疗晚期非小细胞肺癌（NSCLC）的临床效果。方法以2013年9月一2014年11月在北京协和医学院中国医学科学院肿瘤医院进行一线化疗失败的17例晚期NSCLC患者为研究对象。所有患者采用替吉奥联合奈达铂进行二线或多线治疗，21d为1个周期。随访至2015-01-31，观察并记录患者的治疗效果、后续治疗、生存状况及毒副作用情况。结果17例患者中，二线化疗6例（占35．3％），三线及以上化疗11例（占64．7％）。共完成57个化疗周期，疗效评价中获得完全缓解、部分缓解、病情稳定及病情进展的患者数分别为0例、2例（占11．8％）、9例（占52．9％）、6例（35．3％），客观有效率为11．8％（2／17），疾病控制率为64．7％（11／17），中位元进展生存期为3．0个月[95％CI（0．4，6．1）]。截至2015-01-31，有3例患者死亡，14例患者生存，中位总生存期为14．0个月[95％CI（5．1，31．4）]。出现恶心呕吐、白细胞减少、粒细胞减少、贫血、疲乏的患者数分别为13例（76．5％）、12例（70．6％）、12例（70．6％）、9例（52.9％）、9例（52．9％），且69．2％及以上为I～Ⅱ度。除1例患者出现Ⅳ度骨髓抑制外，其他患者的毒副作用均在可耐受范围内，无化疗相关致死事件发生。结论替吉奥联合奈达铂二线或多线治疗晚期NSCLC的疗效较好，生存期较长，且毒副作用较低，应在临床上得到进一步推广和应用。

Objective To investigate the clinical effect of S - 1 combined with Nedaplatin as second - line or further - line chemotherapy for patients with advanced non - small - cell lung cancer （NSCLC） . Methods We enrolled 17 patients with advanced NSCLC who had unsuccessful first - line chemotherapy in the Tumor Hospital of Chinese Academy of Medical Sciences of Peking Union Medical College from September 2013 to November 2014. All the patients were administrated with S - 1 combined with Nedaplatin as second -line or further- line chemotherapy. We took 21 days as a cycle. In the follow- up visits till January, 2015, we recorded the therapeutic effect, follow - up treatment, living condition and toxic and side effects. Results Among the 17 patients, 6 （35.3%） patients were administrated with second - line chemotherapy, 11 （64. 7% ） were administrated with three - line or further - line chemotherapy. A total of 57 chemotherapy cycles were completed. In the therapeutic evaluation, the numbers of patients who had complete remission, partial remission, stabilization of the disease and progress of the disease were 0, 2, 9 and 6, with an objective effective rate of 11.8% （2/17） , a disease control rate of 64. 7% （11/17） and a median progression - free survival of 3 months [95% CI （0. 4, 6. 1） ]. By January 31 in 2015, 3 patients died, 14 patients survived with a median survival of 14. 0 months [ 95% CI （5.1, 31.4）] . The numbers of patients who had nausea and vomiting, leukopenia, granulocytopenia, anemia and fatigue were 13 （76. 5%）, 12 （70. 6% ） , 12 （70. 6% ） , 9 （52. 9% ） and 9 （52. 9%）, and 69. 2% or more than 69.2% of the patients with each symptom were at [ - Ⅱ° level. Except that Ⅳ° myelosuppression occurred in one patient, the toxic and side effects of other patients were all within tolerable range, and no death induced by chemotherapy occurred. Conchlusion The efficacy of S - 1 combined with nedaplatin as second - line or further - line chemotherapy is good in the treatment of NSCLC with long survival time and few toxic and side effects, thus the therapy worthfurther promotion and application.