吉西他滨联合顺铂方案与多西他赛联合顺铂方案治疗非小细胞肺癌的疗效比较

Clinical comparison of gemcitabine plus cisplatin regimen and docetaxel plus cisplatin regimen on non-small cell lung cancer

目的比较吉西他滨联合顺铂方案与多西他赛联合顺铂方案治疗非小细胞肺癌(NSCLC)的临床疗效。方法选取2015年6月至2017年8月郑州大学人民医院收治的NSCLC患者68例,根据治疗方案不同分为DP组与GP组,每组34例。DP组采用多西他赛联合顺铂化疗方案治疗,GP组采用吉西他滨联合顺铂化疗方案治疗。比较两组化疗效果、化疗期间不良反应发生情况,并比较两组化疗前、化疗2个周期后凝血状态[凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]变化情况。结果化疗2个周期后,GP组疾病控制率[79.41%(27/34)]与DP组[76.47%(26/34)]比较,差异未见统计学意义(P>0.05);GP组化疗期间肌肉酸痛、脱发发生率低于DP组,贫血、血小板计数减少、恶心呕吐发生率高于DP组,差异有统计学意义(P<0.05);两组肝肾毒性、白细胞计数减少、皮疹发生率比较,差异未见统计学意义(P>0.05);化疗2个周期后,GP组TT长于DP组,FIB低于DP组,差异有统计学意义(P<0.05)。结论吉西他滨联合顺铂方案与多西他赛联合顺铂治疗NSCLC的疗效相近,吉西他滨联合顺铂方案不良反应主要表现为贫血、血小板计数减少、恶心呕吐,多西他赛联合顺铂方案不良反应主要表现为肌肉酸痛、脱发,临床治疗时需采用不同辅助治疗方法;与多西他赛联合顺铂方案化疗比较,吉西他滨联合顺铂方案能延长凝血酶时间,改善患者体内纤溶功能,更有利于改善患者预后。

Objective To compare the clinical efficacy of gemcitabine combined with cisplatin regimen and docetaxel combined with cisplatin regimen on non-small cell lung cancer(NSCLC).Methods A total of 68 patients with NSCLC admitted to the People’s Hospital of Zhengzhou University from June 2015 to August 2017 were enrolled.They were divided into DP group and GP group according to treatment protocols,with 34 cases in each group.The DP group was treated with docetaxel plus cisplatin chemotherapy,and the GP group was treated with gemcitabine plus cisplatin.The effects of chemotherapy and the incidence of adverse reactions during chemotherapy were compared.And the coagulation status,such as prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),of the two groups before and after chemotherapy was compared.Results After 2 cycles of chemotherapy,the disease control rate of GP group was 79.41%(27/34),and it was 76.47%(26/34)of DP group,however,the difference was not significant(P>0.05).The incidences of muscle soreness and hair loss during chemotherapy in GP group were lower than those of DP group,but the incidences of anemia,platelet count,nausea and vomiting were higher than those of DP group(P<0.05).There was no significant difference in hepatorenal toxicity,decrease of white blood cell count or rash incidence between the two groups(P>0.05).After 2 cycles of chemotherapy,TT in GP group was longer than that in DP group,FIB was lower than that in DP group,and there were significant differences between the two groups(P<0.05).Conclusions The efficacy of gemcitabine combined with cisplatin is similar to that of docetaxel combined with cisplatin in the treatment of NSCLC.Adverse reactions of gemcitabine combined with cisplatin are mainly anemia,thrombocytopenia,nausea and vomiting.Toxic reactions of docetaxel combined with cisplatin are mainly muscle ache and alopecia.Therefore,implement adjuvant therapy in accordance to patient’s complications.Compared with docetaxel combined with cisplatin regimen,gemcitabine combined with cisplatin regimen can prolong the 77,improve the fibrinolytic function and improve the prognosis of patients.