吉西他滨联合顺铂治疗晚期肺鳞癌的疗效及生存情况分析

Efficacy and survival analysis of gemcitabine combined with cisplatin in the treatment of advanced squamous cell lung cancer

目的研究吉西他滨联合顺铂(GP)治疗肺鳞状细胞癌的临床疗效和患者的生存情况。方法回顾性分析96例肺鳞状细胞癌患者的临床资料,其中48例经GP治疗,作为观察组;48例经紫杉醇联合顺铂(TP)治疗,作为对照组。分析两组患者的近期疗效、不良反应发生情况和生存情况。评价GP治疗肺鳞状细胞癌的临床意义。结果观察组患者的临床疗效如完全缓解(CR)、部分缓解(PR)、稳定(SD)、进展(PD)与对照组比较,差异有统计学意义(Z=2.171,P=0.030)。观察组患者的疾病控制率(77.1%)高于对照组(52.1%),差异有统计学意义(χ~2=6.558,P﹤0.05);观察组周围神经毒性的发生率2.1%低于对照组16.7%,差异有统计学意义(P﹤0.05);观察组中位生存时间35个月(95%CI:33.326~36.674)优于对照组25个月(95%CI:18.216~31.784),差异有统计学意义(χ~2=4.136,P=0.042)。结论 GP治疗肺鳞状细胞癌的不良反应轻、疾病控制率高,对延长患者生存时间有重要单位作用,值得临床应用和推广。

Objective To observe the effect of gemcitabine combined with cisplatin（GP regimen） in the treatment of advanced squamous cell lung cancer, and to evaluate the survival of patients. Method 96 cases of squamous cell lung cancer patients were retrospectively analyzed, in which 48 cases were administered with GP regimen（study group）, while another 48 patients were treated with paclitaxel combined with cisplatin（TP regimen）（control group）.The short-term efficacy, incidence of adverse reactions and survival of the two groups of patients were analyzed. And the clinical value of GP regimen in the treatment of squamous cell lung cancer was evaluated. Result The patients achieving complete response（CR）, partial response（PR）, with stable disease（SD） or progressive disease（PD） were generally better than those in the control group, with significant difference observed（Z=2.171, P=0.030）. The disease control rate was 77.1% in study group and was significantly higher than that in the control group at 52.1%, the difference was statistically significant（χ^2=6.558, P〈0.05）; the incidence of peripheral neurotoxicity in the study group（2.1%） was significantly lower than that in the control group（16.7%）（P〈0.05）; and the median survival time in the study group was 35（95% CI： 33.326～36.674） months, which was longer than that in the control group at 25（95% CI： 18.216～31.784）months, demonstrating statistically significant difference（χ^2=4.136, P=0.042）. Conclusion In the treatment of squamous cell lung cancer, the regimen of gemcitabine combined with cisplatin induces mild adverse reactions, but provides high disease control rate, which can prolong the survival time for patients.