含长春瑞滨与含吉西他滨两方案治疗老年非小细胞肺癌的对比研究

Comparative Study of Navelbine and Gemcitabine Regimen for Treatment of Patients with old age Ad-vanced Non-Small Cell Lung Cancer

目的:对比观察长春瑞滨(NVB)联合顺铂(DDP)方案及吉西他滨(Gemcitabine,GEM)联合DDP方案在晚期老年非小细胞肺癌临床疗效及毒性反应。方法:51例晚期老年肺小细胞肺癌随机分为两组,长春瑞滨组25例,吉两他滨组26例。结果:所有被研究对象的症状均有不同程度的改善。长春瑞滨组完全缓解(CR)1例,部分缓解(PR)9例,有效率为40.0％,占西他滨组CR2例,PR9例,有效率为42.3％,两组间差异无显著性(P>0.05),中位生存期(MST)长春瑞滨组为9.2个月,吉西他滨组为9.6个月,中位缓解时间两组分别为4.0个月及4.3个月。毒性反应:长春瑞滨组白细胞Ⅲ/Ⅳ度下降发生率为28％,吉西他滨组白细胞Ⅲ/Ⅳ度下降占23％,但吉西他滨组血小板Ⅲ/Ⅳ度下降有5例,占19％,明显高于长春瑞滨组(P<0.05)。长春瑞滨组发生静脉炎5例,占20％,明显高于吉西他滨组(P<0.05)。结论:吉西他滨联合顺铂与长春瑞滨联合顺铂对晚期老年非小细胞肺癌的近期临床疗效相近,中位生存期及中位缓解期均相似,毒性反应总的较轻,NP及GP方案均可作为治疗晚期老年非小细胞肺癌的一种安全、有效的化疗方案。

Objective:To evaluate and compare the effects and safety of NP(NVB + DDP) regimen and GP(GEM + DDP) regimen for Patients with old age Advanced Non-Small Cell Lung Cancer. Methods:The fifty-one cases of Patients with old age Advanced Non-Small Cell Lung Cancer were randomly divided into NP regimen group and GP regimen group, There are 25 patients in NP group, there are 26 patients in GP group, repeated every 21 days. Results: Also improve the disease-related symptoms of all patients. 2 patients had a complete respones ( CR) ,12 patients had a partial respones ( PR) , For overall response rate of 42. 3% for GEM group and 40. 0% for NVB group. There was no significance (P >0. 05) for overall response rate, the median survival time ( MST) was 9. 6 months and 9. 2 months in GP group and NP group respectively. The disease median response time ( DRT) was 4. 3 months and 4. 0 months in GP group and NP group respectively. MST and DRT were similar in two groups (P >0. 05). WHO grade Ⅲ/Ⅳ leukope-nia occurred in 23% in GP group, and grade Ⅲ/Ⅳ leukopenia occurred in 28% in NP group, grade Ⅲ/Ⅳ thrombocytopenia occured in 19% in GP, it was significantly higher in NP group than these in GP group. The frenquence of phlebitis was 20% in NP group, it was also significantly higher in NP group than these in GP group. Conclusion:There were similar in the overall response rates, MST and DRT in both group, Toxicities were tolerable GP regimen and NP regimen were very good and safe chemotherapeutic regimens for old age advanced NSCLC.