周剂量紫杉醇联合异环磷酰胺治疗晚期非小细胞肺癌23例

Combined chemotherapy of weekly paclitaxel and ifosfamide in the treatment of 23 patients with advanced non-small cell lung cancer

目的 评价周剂量紫杉醇与异环磷酰胺联合化疗治疗晚期非小细胞肺癌的疗效和安全性。方法 紫杉醇 5 0～ 65mg/m2 静脉滴注 ,第 1、8、15天 ,异环磷酰胺 1.3 g/m2 静脉注射 ,第 2～ 4天。每 2 8天重复 ,2～ 3周期为一疗程。使用紫杉醇前常规给予抗过敏等处理 ,异环磷酰胺使用后第 0、4、8小时给予美安解毒。结果 本组完全缓解 1例 ,部分缓解 8例 ,稳定 11例 ,进展 3例 ,总有效率为 3 9.1% ( 9/2 3 ) ,临床受益率为 87.0 % ( 2 0 /2 3 )。化疗后KPS评分显著提高 (P <0 .0 1)。随防 2 0例 ,中位生存期为 8.9月 ,1年生存率为40 % ( 8/2 0 )。全组毒性反应主要为血液学毒性和消化道反应 ,其中白细胞降低发生率为 69.6% ( 16/2 3 ) ,恶心呕吐发生率为 47.8% ( 11/2 3 )。结论 周剂量紫杉醇 +异环磷酰胺联合化疗对晚期非小细胞肺癌有较好的疗效 ,不良反应可耐受 ,安全性高 ,可在临床上推广应用。

Objective To evaluate the efficacy and safety of weekly paclitaxel and ifosfamide in the treatment of advanced non-small cell lung cancer. Methods Twenty-three patients with advanced non-small cell lung cancer received paclitaxel 50--65 mg/m 2 IV weekly on days 1, 8, 15, and IFO 1.3 g/m 2 IV on days 2--4. The schedule was repeated every 28 days for two or three cycles as a course. Results One patient had complete response and eight had partial response. Eleven patients had stable disease and three had progressive disease. The overall response rate was 39.1%. Twenty patients were followed-up. The 1-year survival was 40%(8/20) and the median survival duration was 8.9 months. The main toxicities were hematological toxicity (leukopenia, 69.6%, 16/23) and nausea/vomiting (47.8%, 11/23). Conclusion Combined chemotherapy of weekly paclitaxel and ifosfamide is a good regimen for advanced non-small cell lung cancer with good efficacy and well-tolerated side effects.