吉西他滨注射液联合顺铂注射液治疗中晚期非小细胞肺癌患者的临床研究

Clinical trial of gemcitabine injection combined with cisplatin injection in the treatment of patients with advanced non-small cell lung cancer

目的观察吉西他滨注射液联合顺铂注射液治疗中晚期非小细胞肺癌患者的临床疗效和安全性。方法 84例患者均给予1 250 mg·m^(-2)吉西他滨,静脉注射,第1,8天+40 mg·m^(-2)顺铂,静脉注射,第1,3天。所有患者均治疗4个疗程,一个疗程21 d。比较患者治疗前后中性粒细胞/淋巴细胞的比值(NLR)、血小板/淋巴细胞的比值(PLR)及肿瘤标志物水平的变化,以及药物不良反应的发生情况。结果低NLR组和高NLR组的总有效率分别为78.05%(32例/41例)和65.12%(28例/43例),差异无统计学意义(P>0.05)。低PLR组和高PLR组的总有效率分别为78.05%(32例/41例)和62.79%(27例/43例),差异无统计学意义(P>0.05)。治疗前和治疗后的NLR分别为5.84±3.45和3.57±5.42,PLR分别为294.43±69.45和169.42±64.38,差异均有统计学意义(均P<0.05)。治疗后,所有患者的癌胚抗原、糖抗原199、神经元特异性烯醇化酶和细胞角蛋白片段19水平均较治疗前明显降低。药物不良反应以恶心呕吐和出血为主,其总药物不良反应发生率为38.10%。结论吉西他滨注射液联合顺铂注射液治疗中晚期非小细胞肺癌能在一定程度上抑制炎症反应,减少肿瘤负担,但应关注用药后的药物不良反应。

Objective To observe the clinical efficacy and safety of gemcitabine injection combined with DDP injection in the treatment of advanced non-small cell lung cancer(NSCLC).Methods A total of 84 patients with advanced non-small cell lung cancer were treated with 1250 mg·m^(-2) gemcitabine intravenously on the 1st and 8th day,and 40 mg·m^(-2) cisplatin on the 1st and 3rd day.All patients were treated for 4 courses with 21 days per course.The index level changes of neutrophils/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and tumor markers,and the drug adverse reactions between groups were observed and compared.Results The total effective rates of the low NLR group and NLR group were 78.05%(32 cases/41 cases)and 65.12%(28 cases/43 cases)without significant difference(P>0.05).The total effective rates of the low PLR group and PLR group were 78.05%(32 cases/41 cases)and 62.79%(27 cases/43 cases)without significant difference(P>0.05).The NLR levels before and after treatment were 5.84±3.45 and 3.57±5.42,and the PLR levels before and after treatment were 294.43±69.45 and 169.42±64.38,the differences were statistically significant(all P<0.05).After treatment,the levels of carcinoembryonic antigen,carbohydrate antigen 199,neuron specific enolase and cytokeratin fragment 19 in all patients were significantly lower than those before treatment.The adverse drug reactions were nausea,vomiting and bleeding,and the total incidence of adverse drug reactions was 38.10%.Conclusion Gemcitabine injection combined with cisplatin injection in the treatment of advanced non-small cell lung cancer can inhibit inflammation and reduce tumor burden to a certain extent,but attention should be paid to the adverse drug reactions.