紫杉醇脂质体的制备及其联合顺铂在老年非小细胞肺癌用药过程中不良反应的疗效观察

Observation of Paclitaxel Entrapped Liposomes Preparation Combined with Cisplatin in the Treatment of the Senile Non -small Cell Lung Cancer

目的：研究紫杉醇脂质体的制备及其联合顺铂在老年非小细胞肺癌（NSCLC）用药过程中的疗效观察及不良反应。方法：将2012年11月～2013年10月于我院接受放疗的老年NSCLC患者116例纳入本次研究，并依照随机数字表法1：1分为实验组与对照组，两组基线资料无统计学差异（P〉0．05）。实验组行紫杉醇脂质体联合顺铂治疗，对照组行紫杉醇联合顺铂治疗。比较两组临床疗效、化疗前后CRP、TNF—α、IL-6等炎性因子水平及不良反应。结果：实验组控制率（DCR）（70．69％）与对照组DCR率（68．97％）无统计学差异（P〉0．05）。实验组总有效率（RR）（29．31％）与对照组RR率（25．86％）无统计学差异（P〉0．05）。实验组无进展生存时间（PFS）为（163．69±16．54）d与对照组（159．49±16．39）d无统计学差异（P〉0．05）。两组化疗后CRP、TNF-α、IL-6水平高于化疗前，组内化疗前后均有统计学差异（P〈0．05）。两组化疗后CRP、TNF—α、IL-6水平均无显著统计学差异（P〉0．05）。两组血小板减少、白细胞减少、中性粒细胞减少、血红蛋白降低、天冬氨酸转氨酶升高、谷氨酸转氨酶升高、恶心呕吐、脱发、末梢神经炎等不良反应发生率无统计学差异（P〉0．05）；实验组呼吸困难、肌肉痛、皮疹、面部潮红等不良反应发生率低于对照组，有统计学差异（P〈0．5）。结论：紫杉醇脂质体联合顺铂治疗老年NSCLC疗效显著，可有效降低呼吸困难、肌肉痛、皮疹、面部潮红等不良反应发生率，提高老年患者的耐受性，值得应用于临床。

OBJECTIVE： To study the observation of paclitaxel entrapped liposomes preparation combined with cisplatin in the treatment of the senile non - small cell lung cancer. METHODS： 116 senile NSCLC patients selected from our hospital from November 2012 to October 2013 were randomly divided into two groups, 58 cases in each group. The experiment group was treated by paclitaxed entrapped liposomes combined with cisplatin, while the control group by paclitaxel combined with cisplatin clinical effect, CRP, TNF -α, IL -6 index changes after chemotherapy and side effect were analyzed. RESULTS： There was no statistical difference in DCR rate in the control group （68.97%） and experiment group （70. 69% ） （P 〉0.05）. There was no statiscal difference in PFS in the experiment group （ 163.69 ± 16. 54） d and the control group （ 159.49 ± 16. 39 ） d （ P 〉 0.05 ）. After chemotherapy the levels of CRP, TNF alpha and IL - 6 were increased. And there was statistical significant difference （ P 〈 0. 05 ）. However there was no sta- tistically significant difference in these index after chemotherapy in the two groups （ P 〉 0.05 ）. There were no statistical difference in the adverse reactions such as thrombocytopenia, leukopenia and neutropenia, lower hemoglobin, elevated aspartate trausaminase,glutamic acid transaminase eleations, nausea and vomiting, hair loss, peripheral neuritis and so on in the two groups. There were statistically significant difference （ P 〈 0. 05 ）. Insidence rate of breathing difficulty muscle pain, rashes and facial flush in the experi- ment group was lower than the those in the contral group. CONCLUSION： Paclitaxel liposome combined with cisplatin can treat senile NSCLC effectivly and reduce the difficulty in breathing, muscle pain, rashes, facial flush and so on.