多西紫杉醇联合顺铂治疗晚期非小细胞肺癌

Combination of docetaxel and cisplatin in the treatment of advanced non-small cell lung cancer

目的 观察多西紫杉醇联合顺铂治疗晚期非小细胞肺癌的疗效及毒副反应。方法 对经病理学或细胞学证实的 40例晚期非小细胞肺癌患者给予多西紫杉醇与顺铂联合治疗 ,其中多西紫杉醇75mg/m2 ,静脉滴注 ,第 1天 ,顺铂 75～ 80mg/m2 ,静脉滴注 ,第 1天或分为第 1～ 3天 ,2 1天为一周期 ,每例患者治疗两周期以上。结果 全组完全缓解 1例 ,部分缓解 16例 ,稳定 15例 ,进展 7例 ,总有效率为 43.6 %。初治组有效率为 44.4% ,复治组有效率为 40 .9% ,两组间比较有效率差异无显著性 (P >0 .0 5 )。最常见的毒副反应为骨髓抑制 ,Ⅲ +Ⅳ度白细胞和血小板下降率分别为 17.5 %和 12 .5 % ,有一例因严重骨髓抑制致颅内出血死亡 ,其余毒副反应均轻微可耐受。结论 多西紫杉醇联合顺铂一线治疗或二线治疗晚期非小细胞肺癌均有较好的疗效 ,毒性可以耐受 。

Objective To evaluate the efficacy and toxicity of the combination of docetaxel and cisplatin in the treatment of patients with advanced non-small cell lung cancer (NSCLC). Methods Forty patients with locally advanced (stage Ⅲ) or metastatic (stage Ⅳ) NSCLC were enrolled into the study. The patients received docetaxel 75 mg/m 2 on day 1, and cisplatin 75--80 mg/m 2 on day 1 or days devided into 1--3 of a 21-day cycle. Each patient should complete two cycles. Results An objective response rate was obtained in 43.6% of 39 patients (one complete and 16 partial response), whereas 15 patients had stable disease and 7 patients were progressive. The response rate was 44.4% (8/18) in the initial patients, and 42.9% (9/21) in the retreated patients. No significant difference existed between the two groups (P>0.05). The main toxicities were leukopenia (17.5% in grade Ⅲ+Ⅳ) and thrombocytopenia (12.5% in grade Ⅲ+Ⅳ). One patients died of intracranial hemorrhage. Conclusion The combination of docetaxel and cisplatin is a feasible, well-tolerated and active scheme in the first-line or second-line treatment of advanced NSCLC. Great attention must be paid to the possible severe bone marrow depression of the regimen.