CAP方案联合维拉帕米治疗晚期肺腺癌疗效分析

Treatment effects of CAP combined with verapamil in chemotherapy of patients with advanced lung adenocarcinoma

目的 观察环磷酰胺 +阿霉素 +顺铂 (CAP)方案联合维拉帕米与单用CAP方案治疗晚期肺腺癌的疗效、毒副作用差异。方法 1998年 4月至 2 0 0 1年 12月 ,经病理证实且KPS评分≥ 60分的 5 6例晚期 (Ⅲb期或Ⅳ期 )初治肺腺癌病人被分为A、B组 ,其中A组 3 0例 ,B组 2 6例 ,分别采用CAP方案和CAP联合维拉帕米方案治疗 ,每 2 1d重复 ,共 3周期。结果 A组总有效率 (CR +PR)低于B组 ,分别为 2 6.7%和 3 8.5 % ,二者比较差异有显著意义 (P <0 .0 5 ) ;A、B组中位生存期分别为 5 .4个月和 7.3个月 ,两组比较差异有显著意义 (P <0 .0 5 ) ;两组治疗副反应相似 ,主要毒副反应仍为骨髓抑制及胃肠道反应 ,联合维拉帕米治疗所增加的毒副反应轻微。结论 CAP联合维拉帕米治疗可提高晚期肺腺癌的化疗效果 ,延长患者生存期 ,毒副反应可以耐受 ,具有进一步推广应用价值。

Objective To evaluate the therapeutic efficacy and side effects of cyclopnosphamide, adriamycin, cisplatin (CAP) or CAP combined with verapamil(VPL) in chemotherapy of patients with advanced lung adenocarcinoma. Methods A total of 56 patients(male: 27, female: 29, average age: 48 years old, age range: 32-78 years old) with stage Ⅲb/Ⅳ lung adenocarcinoma confirmed pathologically from April 1998 to December 2001 were divided into two groups: group A(30 patients), treated with cyclophosphamide (CTX, 600 mg·m -2 ·d -1 ) on days 1 and 8, adriamycin (ADM, 40 mg/m 2) on day 1, and cisplatin (CDDP, 30 mg·m -2 ·d -1 ) on days 1, 2 and 3 and group B(26 patients), treated with the same dose of CTX, ADM and CDDP and an additional oral VPL treatment (60 mg t.i.d . on days 1-7). Each of the 3 cycles was repeated every 21 days. Results The patients in group A had a lower response rate (26.7% vs 38.5%, P <0.05) than those in group B, but patients in group B had a longer overall survival (OS) (median OS: 5.4 months vs 7.3 months, P <0.05). The treatment was well tolerated and the side effects were similar in both groups. Little side effects attributed to VPL were found. Conclusion CAP combined with verapamil can improve the effect of chemotherapy in the treatment of patients with advanced lung adenocarcinoma.