异环磷酰胺、诺维本与顺铂联合化疗方案治疗晚期非小细胞肺癌的临床观察

EFFECT OF IFOSFAMIDE ,VINORELBINE AND CISPLATIN COMBINATION CHEMOTHERAPY IN ADVANCDE NON-AMALL-CELL LUNG CANCER

目的 :观察以IFO、NVB与DDP组成的联合化疗方案治疗晚期非小细胞肺癌的临床疗效及不良反应。方法 :2 1例给予INP方案化疗 ,NVB2 5mg/m2 静脉滴注第 1、8天 ;IFO2 g/d静脉滴注第 1～ 5天 ;DDP80mg/m2 静脉滴注第 1～ 3d。 35例给予NP方案化疗 ,除不用IFO外 ,余同INP组。以上方案均每 2 1～ 2 8d重复。每例至少完成两周期化疗方可评价疗效。结果 :NIP组总有效率 (CR +PR) 5 2 .4 % ;NP组总有效率4 0 %。两组比较 ,差异无显著性 (P =0 .2 6 6 )。对于复治病人INP方案疗效似高于NP方案 ,但差异无显著性。不良反应主要是血液毒性及消化道反应及静脉炎、脱发 ,INP方案消化道的毒性作用较NP方案大 ,其它系统毒性较小 ,患者能耐受。结论 :两者均为治疗晚期非小细胞肺癌的有效方案 ,INP方案是否可作为既往治疗效果不理想的二线方案 ,值得进一步探讨。

Objective:To observe the efficacy and toxicity of ifosfamide(IFO), vmorelbine (NVB) and cisplatin (DDP) combination chemotherapy (INP regimen) in advanced none small cell lung cancer(NSCLC). Methods:21 cases were treated as study group with INP regimen (NVB 25mg/m 2 iv gtt d1,d8;IFO2g/d iv gtt d1～5; DDP 80mg/m 2 iv gtt d1～3).35 cases treated as control with NP regimen(NVB 25mg/m 2 iv gtt d1,d8; DDP 80mg/m 2 iv gtt d1～3). Both regimens are repeated in 21～28 days. For needs of evaluation, all patients must complete at least two cycles.Results:The total response rate (PR+CR) in INP and NP regimen group was 52.4% and 40% respectively. The difference between two groups have no statistical signific ance (P=0.266). The INP regiment chemotherapy was seemed more effectively than NP in retreatment patient but no statistical significance was found .The main adverse reactions of chemotherapy were leucopenia, gastrointestinal discomfort, alopecia and phlebitis which patients could endure. Moregastrointestinal discomfort in INP group was found .Conclusion:Both INP and NP combined chemotherapy was an efficient and tow-toxicity regimen in the treatment of advanced NSCLC.1NP combination chemotherapy could be use as second line treatment in NSCLC.