榄香烯联合NP方案综合治疗晚期非小细胞肺癌的临床观察

Clinical Observation of Elemene Combined with NP Chemotherapy for Advanced Non-small Cell Lung Cancer

目的观察榄香烯联合NP化疗方案、沙利度胺以及化疗前24 h口服质子泵抑制剂(PPI)综合治疗晚期非小细胞肺癌的疗效。方法将136例晚期非小细胞肺癌患者随机分为对照组和综合治疗组,各68例。综合治疗组给予长春瑞滨、顺铂化疗及口服沙利度胺、静脉滴注榄香烯注射液,化疗前24 h口服质子泵抑制剂(PPI)等治疗;对照组给予长春瑞滨、顺铂化疗。21天为1个周期,2~3个周期后评价疗效。结果综合治疗组有效率(CR+PR)为76.5%(52/68),明显高于对照组48.5%(33/68);综合治疗组1年、2年、3年生存率分别为88.2%、57.4%、33.8%,中位生存期为22个月;而对照组分别为60.3%、29.4%、13.2%,中位生存期为9个月。2组生存差异比较,有统计学意义(P<0.01)。KPS评分及体重变化综合治疗组明显好于对照组(P<0.01)。综合治疗组及对照组Ⅱ度及Ⅱ度以上胃肠道反应总发生率分别为16.2%(11/68)和47.1%(32/68),2组间差异有统计学意义(P<0.01)。结论榄香烯联合NP化疗方案、沙利度胺以及化疗前24 h口服质子泵抑制剂(PPI)综合治疗晚期非小细胞肺癌能明显提高患者近期治疗有效率和生存率,降低肿瘤耐药,提高化疗药物的疗效,增强机体免疫力,提高生存质量。

Objective To observe the curative effects of comprehensive treatment of elemene,NP chemotherapy,thalidomide and oral PPI 24 hours before chemotherapy for advanced non-small cell lung cancer( NSCLC). Methods 136 advanced non-small cell lung cancer patients were randomly divided into the control group and the comprehensive treatment group,each with68 cases. The comprehensive treatment group were given elemene,thalidomide combined with navelbine,cisplatin chemotherapy,and oral PPI 24 hours before chemotherapy. The control group were given navelbine,cisplatin chemotherapy. 21 days as a cycle,curative effects were evaluated after 2 or 3 cycles. Results Efficiency( CR + PR) of the comprehensive treatment group was76. 5%( 252 /68),which was obviously higher than that of the control group 48. 5%( 33 /68). 1-,2-,3-year survival rates of the comprehensive treatment group were 88. 2%,57. 4%,33. 8% respectively,and those of the control group were 60. 3%,29. 4%,13. 2% respectively. The median survival time of the comprehensive treatment group and the control group were 22 months and 9months respectively,there were significant differences( P < 0. 01). KPS score and weight change of the comprehensive treatment group were better than those of the control group( P < 0. 01). Incidence of Ⅱdegree and Ⅱdegree above gastrointestinal reactions were 16. 2%( 11 /68) and 47. 1%( 32 /68),there were statistically significant difference( P < 0. 01). Conclusion Elemene,thalidomide combined with navelbine,cisplatin chemotherapy,and oral PPI 24 hours before chemotherapy can significantly improve short-term efficiency and survival rate of advanced non-small lung cancer patients,reduce the resistance of antineoplastic drugs,enhance curative effect of chemotherapeutic drugs,heighten the function of immune system of the body and improve the life quality of patients.