长春瑞滨联合顺铂方案治疗晚期非小细胞肺癌

Vinorelbine combined with cisplatin in advanced stage non-small-cell lung cancer

目的:研究长春瑞宾(NVB)联合顺铂(DDP)方案(NP方案)治疗晚期非小细胞肺癌(NSCLC)的疗效及毒副作用 方法:91例经病理或细胞学诊断非小细胞肺癌患者,其中腺癌56例,鳞癌27例,肺泡细胞癌4例,大细胞肺癌3例;细胞学涂片为癌细胞1例。初治80例,复治11例;Ⅲ期32例(Ⅲa期2例,Ⅲb期30例),Ⅳ期59例,采用长春瑞滨(NVB)25 mg/m2,第1、8天静滴;顺铂(DDP)90-100 mg/m2静滴,21天为1个周期 结果:部分缓解(PR)37例,稳定(SD)30例,进展(PD)24例,总有效率为40.6%(95% CI:30.5%-50.7%)。中位进展期5月(95%CI:4-6月),中位生存期13月(95% CI:11-15月),一年生存率52.7%(95%CI:42.4%-62.9%)。WHOⅢ Ⅳ度白细胞下降占40.7%,为主要血液毒性 结论:长春瑞滨联合顺铂治疗晚期NSCLC疗效确切,毒副反应性可耐受,价格适中,为符合国情的治疗晚期非小细胞肺癌的方案。

Purpose: To evaluate the efficacy and toxicity of vinorelbine combined with cisplatin (NP regimen) in the treatment of advanced non-small-cell lung cancer ( NSCLC). Methods: ninety-one patients with advanced NSCLC were confirmed by pathology or cytology. There were 56 patients with lung adenocarcinoma, 27 with squamous carcinoma and 4 with alveoli cell cancer, 3 with large-cell lung cancer, one case diagnosed by cytological smear section. The eighty patients had no prior chemotherapy and 11 were those without received previously chemotherapy. Thirty-two patients had stage Ⅲ disease and 59 had stage Ⅳ. Results: Partial response was observed in 37 patients with an overall response rate of 40. 7% (95%CI:30. 5%-50. 7%). Median time to progression (TTP) were 5 months(95% CI: 4-6 months). Median survival duration was 13 months (95% CI: 11-15months), one-year survival rate was 52. 7% ( CI: 42. 4%-62. 9%). The dose limiting toxicity was neutropenia that was observed in 87. 9% of the patients (40.7% in grades Ⅲ and Ⅳ). The remission response rate is 40. 6% , TTP is 5 months, MS is 13 months and 1-year survival rate was 52.7% . Conclusions: The results indicate NP regimen for advanced NSCLC is promise, and the toxicities are tolerable.