PD-1/PD-L1免疫检查点抑制剂在肺癌治疗中的临床研究进展分析

在医学研究不断发展的背景下,免疫疗法取得突出成果。目前,针对程序性死亡受体1(programmed death 1, PD-1)或程序性死亡配体1(programmed death-ligand 1, PD-L1)免疫检查点抑制剂的研究已经取得重大突破,以上物质在患者体内形成一定的阻断机制,对于宿主细胞的改变有重要作用,其中最为明显的是对PD1/PD-L1的通路阻断,并能激活免疫免疫应答,对于癌症的进展等有影响,其中临床常见的有肺癌等。免疫检查点抑制剂的研发有效促进肺癌治疗向更加安全、有效的阶段进展。基于此,为研究PD-1/PD-L1免疫检查点抑制剂在肺癌治疗中的临床进展,本综述立足PD-1/PD-L1的生物学作用,分析了PD-1/PD-L1抑制剂在肺癌治疗中的临床研究进展,希望能为相关工作提供参考。

鸦蛋子油乳注射液用于晚期非小细胞肺癌化疗患者27例效果观察

目的提高晚期非小细胞肺癌的治疗水平。方法将54例晚期非小细胞肺癌患者随机分为观察组和对照组各27例,两组均予GP(吉西他滨、顺铂)方案化疗,观察组在此基础上将鸦蛋子油注射液20 ml加入5%葡萄糖250 ml内静滴,两组均21 d为1周期,化疗4个周期。结果观察组及对照组总有效率分别为77.8%、48.2%,疾病控制率分别为96.3%、88.9%,P均<0.05。两组不良反应(骨髓抑制、胃肠道反应、腹泻、便秘)发生率无显著差异,且均能耐受。结论鸦蛋子油乳注射液可提高晚期非小细胞肺癌患者的化疗效果,且无明显不良反应。

化疗对晚期非小细胞肺腺癌患者中医证候的影响

目的:探讨培美曲塞联合顺铂(PP)化疗方案对原发性晚期非小细胞肺腺癌患者中医证候的影响。方法:选取2015年1月至2017年1月新乡市中心医院肿瘤内科收治的经病理学检查明确确诊的晚期原发性非小细胞肺腺癌患者112例,进行PP化疗方案治疗,于化疗前8 d和化疗后第8天、16天分别观察患者的中医证型、舌象以及脉象。结果:化疗后第8天脾虚痰湿证患者(12.50%)明显少于化疗前8 d脾虚痰湿证患者(40.08%),差异有统计学意义(P<0.05);化疗后第8天气阴两虚证(27.68%)和气滞血瘀证(25.00%)患者明显多于化疗前8 d气阴两虚证(9.82%)和气滞血瘀证(7.14%)患者(P<0.05);化疗后8 d淡红舌(25.89%)、腻舌(11.61%)患者明显少于化疗前第8天淡红舌(36.61%)、腻舌(25.00%)患者(P<0.05);化疗后8 d红舌(33.93%)、紫暗舌(19.64%)、光剥苔(44.64%)患者明显多于化疗前第8天红舌(22.32%)、紫暗舌(5.36%)、光剥苔(21.43%)患者;化疗后8 d细脉(28.57%)、滑脉(9.82%)患者患者明显少于化疗前第8天细脉(37.50%)、滑脉(25.89%)患者患者,差异有统计学意义(P<0.05);化疗后8 d细数脉(22.32%)、弦脉(25.00%)患者明显多于化疗前第8天细数脉(9.82%)、弦脉(7.14%)患者,差异有统计学意义(P<0.05)。结论:原发性晚期非小细胞肺腺癌患者行PP方案前后中医证候变化有规律可循,化疗后气阴两虚证、气滞血瘀证,可在化疗前增加相应中医药干预治疗。

顺铂联合紫杉醇治疗晚期肺小细胞癌的效果观察

目的：观察顺铂联合紫杉醇在晚期肺小细胞癌患者的治疗中临床效果。方法：将我院收治的114例晚期肺小细胞癌患者平均分成观察组和对照组,观察组采用顺铂联合紫杉醇治疗,对照组采用紫杉醇治疗,疗程结束后对两组治疗方案的疗效进行评价。结果：观察组治疗的总有效率明显高于对照组（P〈0.05）;毒副反应发生率明显低于对照组（P〈0.01）。结论：应用顺铂联合紫杉醇对晚期非小细胞肺癌的治疗有着非常突出的疗效,值得临床推广应用。

血清CEA、血浆D-二聚体对晚期非小细胞肺腺癌治疗效果的评估价值

目的探讨血清癌胚抗原(carcinoembryonic antigen,CEA)、血浆D-二聚体对晚期非小细胞肺腺癌化疗效果评估的应用意义。方法选取60例经病理学确诊为晚期非小细胞肺腺癌的患者,以随机分配的原则分为两组,对照组30例,采用单一药物培美曲塞的治疗方式。联合组30例,采用培美曲塞联合铂类药物的治疗方式。观察两组患者治疗前后血清CEA、血浆D-二聚体水平的变化;观察两组患者经治疗后的近期疗效和不良反应发生率并应用日常生活能力(Bather指数)评估患者的生存质量。结果两组患者化疗前D-二聚体及血清CEA比较差异无统计学意义(P>0.05);对照组、联合组化疗后与化疗前D-二聚体及血清CEA比较,明显降低,差异有统计学意义(P<0.05);联合组与对照组化疗后D-二聚体及血清CEA比较,明显降低,差异有统计学意义(P<0.05)。治疗后联合组患者的近期疗效明显优于对照组患者(χ^2=4.286;P=0.038);联合组患者经治疗后的Bather指数较对照组升高,差异有统计学意义(t=4.87,P=0.000);两组患者治疗后不良反应发生率差异无统计学意义(P>0.05)。结论晚期非小细胞肺腺癌患者D-二聚体水平可间接评估治疗效果;血清CEA可用于晚期非小细胞肺腺癌治疗疗效和进展评估的敏感指标。对晚期非小细胞肺腺癌患者采用培美曲塞联合铂类药物的方式治疗,可以明显改善患者的近期疗效,提高患者的生存质量,同时并不会导致不良反应发生率的增加。

扶正减毒方联合化疗治疗中晚期非小细胞肺腺癌的临床疗效观察

观察扶正减毒方联合化疗对中晚期非小细胞肺腺癌的减毒和协同作用。方法:抽取患者分组,干预治疗后对两组患者进行比较。结果:通过干预治疗,两组患者有明显数据区别,详细数据见文内。结论:扶正减毒方联合化疗可改善患者的生活质量和临床症状,提高患者的依从性使化疗顺利进行。

新疆地区维吾尔族和汉族晚期非小细胞肺癌患者三磷酸腺苷结合盒转运体C2基因多态性差异研究

目的探讨新疆地区维吾尔族和汉族晚期非小细胞肺癌(NSCLC)患者三磷酸腺苷结合盒转运体C2(ABCC2)基因多态性差异。方法选择2013年3月—2014年8月就诊于新疆医科大学附属肿瘤医院肺内一科的晚期NSCLC患者226例,其中维吾尔族110例(A组),汉族116例(B组),采用限制性片段长度多态性聚合酶链式反应检测ABCC2基因rs717620、rs2273697、rs3740066位点多态性。结果两组患者ABCC2基因rs717620位点基因型及等位基因分布频率比较,差异均有统计学意义(P<0.05);而两组患者ABCC2基因rs2273697、rs3740066位点基因型及等位基因分布频率比较,差异均无统计学意义(P>0.05)。两组腺癌患者ABCC2基因rs717620位点基因型和等位基因分布频率比较,差异有统计学意义(P<0.05)。两组鳞癌患者ABCC2基因rs717620位点基因型和等位基因分布频率比较,差异无统计学意义(P>0.05)。两组ⅢB、Ⅳ期患者ABCC2基因rs717620位点基因型和等位基因分布频率比较,差异均有统计学意义(P<0.05)。结论新疆地区维吾尔族、汉族晚期NSCLC患者ABCC2基因rs2273697、rs3740066位点多态性无明显差异,而rs717620位点多态性存在差异。

Clinical observation of Shenmai injection in the treatment for adverse reactions of chemotherapy on advanced non-small cell lung cancer

Objective: To observe the efficacy of Shenmai injection in the treatment for adverse reactions of chemotherapy on advanced non-small cell lung cancer (NSCLC). Methods: 45 NSCLC patients with stages IIIb-IV were randomly divided into two groups: the treatment group (treated by chemotherapy combined with Shenmai injection) and the control group (treated by chemotherapy only). The efficacy of the two groups was evaluated after 3 cycles of treatment. Results: There was no significant difference between the two groups in the recent curative effects (P > 0.05), while there were significant differences between them in Karnofsky score and weight (P < 0.05). The treatment group was better than the control group in preventing leucopenia and decreased hemoglobin, and significant differences were found between them (P < 0.05). The incidence of thrombocytopenia, nausea and vomiting, hepatic and renal dysfunction in the treatment group was lower than that in the control group, but no significant differences were found between them (P > 0.05). Conclusion: Shenmai injection would not influence the efficacy of chemotherapy on advanced NSCLC patients, while it could improve the quality of life, increase the body weight of patients, alleviate adverse reactions of chemotherapy as myelosuppression so as to improve the tolerance of organism to chemotherapy.

Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer： a meta-analysis

Objective： To evaluate the clinical efficacy of Shenqi Fuzheng injection combined with gemcitabine plus cisplatin（GP） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： we performed a systematicsearch in the electronic databases such as Cochrane Library, Pubmed, Embase, Chinese Journal Full-text Database,Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database andWanfang Database up to 30 January 2017. Randomized controlled trials （RCT） of Shenqi Fuzheng Injectioncombined with GP chemotherapy in the treatment of advanced NSCLC were searched, and all the RCTs wereconducted on methodological quality assessment. Data extraction and data analysis were according to standards ofCochrane systematic review. Results： Eight trials were included including a total of 701 patients. Meta-analysisresults： Shenqi Fuzheng injection combined with GP chemotherapy could significantly improve the functionalstatus of patients with NSCLC （OR = 3.44, 95% CI [2.26, 5.25], P 〈 0.0001） and clinical treatment efficacy （OR =（OR = 0.31, 95%CI [0.20, 0.47], P 〈 0.0001. The rate of leukopenia （OR = .31, 95%CI [0.20,0.47], P 〈 0.0001）,thrombocytopenia （OR = 0.58, 95%CI [0.37, 0.91], P = 0.020）, hemoglobin decline （（OR = 0.31, 95%CI [0.16,0.59], P = 0.0004） and incidence of gastrointestinal reactions （OR = 0.58,P 〈 0.05） could be reduced. Conclusion：Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced NSCLC obtainedsignificantly clinical efficacy. The quality of the literature incorporated is low, the conclusion requires high-qualityresearch to further prove.

Clinical observation of gemcitabine and concomitant three-dimensional conformal radiotherapy in the treatment of locally advanced non-small cell lung cancer

Objective： To evaluate the clinical effect of gemcitabine and concurrent three-dimensional conformal radiation therapy （3D-CRT） for locally advanced non-small cell lung cancer （NSCLC）. Methods： From April 2002 to June 2005, 38 patients with inoperable stage Ⅲ NSCLC were treated with gemcitabine and 3D-CRT simultaneously. Chemotherapy consisted of intravenously gemcitabine 350 mg/m^2 on days 1, 8, 15, 22, 29, 36.3D-CRT was delivered up to a total dose of 60-64 Gy with a 2.0 Gy dose fraction per day, 5 days per week. Results： The overall response rates of primary tumor and mediastinum metastatic node were 86.8% （33/38） and 90.6% （29/32） respectively, and 91.7% （22/24） and 78.6% （11/14） for squamous cell carcinoma and adenocarcinoma respectively. The acute side effects of patients were mostly myelosuppression, nausea, vomiting, radiation-induced esophagitis and pneumonitis （RTOG 1/11）, however, all of them were cured. Conclusion： Concurrent application of gemcitabine and 3D-CRT can improve the overall response rate for locally advanced NSCLC without aggravating the side effects.

Comparison of efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer

Objective: To compare the efficacy and toxicity between gemcitabine plus cisplatin and plus carboplatin in first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods: Gemcitabine 1000 mg/m2 iv, d1, 8; cisplatin 75 mg/m2 iv, d1, or 25 mg/m2 iv, d1-3; carboplatin AUC = 5 iv, d1; repeated every 21 days. Results: All 76 cases were available for objective response. Gemcitabine + cisplatin (GCis) group: among 33 cases, CR 1 case, PR 13 cases, MR 3 cases, SD 7 cases, PD 9 cases, response rate, disease control rate, time to progress (TTP), median survival time (MST) and 1-, 2-year survival rates were 42.42% (14/33), 72.73% (24/33), 5 months, 14 months and 66.67% (22/33), 12.12% (4/33), respectively; Gemcitabine + carboplatin (GCarb) group: among 43 cases, PR 13 cases, MR 11 cases, SD 7 cases, PD 12 cases, the results while comparing with those of GCis group were 30.23% (13/43), 72.09% (31/43), 4 months, 11 months and 48.84% (21/43), 2.33% (1/43), respectively. Among them, only MST between the two groups had significant statistic difference (χ2 = 2.45, P = 0.017). Mild to modest myelo-suppression as well as nausea and vomiting were observed. Conclusion: Both GCis and GCarb regimens had active and well-tolerated toxicity for advanced NSCLC. Cisplatin-based chemotherapy yields a substantial effective advantage over carboplatin-based regimens. Therefore, carboplatin and cisplatin are not equal-active and that cisplatin-based doublet regimens should remain the standard first-line therapy for patients with advanced NSCLC with good performance status.

Clinical study on concurrent chemoradiotherapy combined with Kanglaite injection in the treatment of regionally advanced unresectable non-small cell lung cancer

Objective： To evaluate the clinical effects and toxicity of concurrent chemoradiotherapy combined with Kanglaite injection in the treatment of regionally advanced unresectable non-small cell lung cancer. Methods： 48 patients with regionally advanced unresectable non-small cell lung cancer were randomized to two groups, 25 patients in the combination group （concurrent chemoradiotherapy ＋ Kanglaite） and 23 patients in the control group （concurrent chemoradiotherapy）. The combination group received chemotherapy of vinorelbine （NVB） plus cisplatin （DDP） regimen, radiotherapy was given with conventional fraction in 2 Gy per fraction and five fractions per week concurrently. The total tumor doses were 56-60 Gy. Combined with Kanglaite injection 200 mud for twenty-one days for two courses in the combination group, the control group was chemoradiotherapy only. Effects and toxicities were evaluated according to the criteria of WHO. Results： The CR rates in the combination group and control group were 24.0% （6/25） and 13.0% （3/23）, respectively （P 〉 0.05）. Response （CR ＋ PR） rates of combination group were 76.0 % （19/25） and 69.6% （16/23） in control group, P 〉 0.05. The incidence rates of grades 3-4 leukocytopenia, grades 3-4 digestive system （nausea and vomiting） and grades 3-4 esophagitis in the combination group and control group were 40.0% （10/25）, 8.0% （2/25）, 16.0% （4/25） and 69.6% （16/23）, 34.8% （8/23）, 43.5% （10/23）, respectively （P 〈 0.05）. KPS and body weight score significantly increased in combination group after the combined treatment, P 〈 0.05. Conclusion： Concurrent chemoradiotherapy combined with Kanglaite injection can relieve side effects of chemoradiotherapy in the treatment of regionally advanced unresectable non-small cell lung cancer, and improve quality of life. Kanglaite injection may increase effective rate of regionally advanced unresectable non-small cell lung cancer combined with concurrent chemoradiotherapy.

Clinical observation of pemetrexed on advanced non-small-cell lung cancer

Objective： The aim of our study was to observe the efficacy and toxicity of 50 cases of advanced non-small cell lung cancer （NSCLC） patients treated by pemetrexed. Methods： Fifty patients, including 29 females and 21 males, with a median age 62 years （35–82 years）, 13 of whom were treated with pemetrexed only and the left 37 cases were treated with pemetrexed combined with platinum in the Department of Oncology, Renmin Hospital of Wuhan University from June 2006 to March 2009. Single agent regimen： patients received pemetrexed 500 mg/m2 on day 1 with every 21 days. Combination regimen： patients received pemetrexed 500 mg/m2 on day 1 and carboplatin 300 mg/m2 on day 1 or cisplatin 35 mg/m2 on day 1 to day 3 or nedaplatin 80 mg/m2 on day 1 by intravenous infusion with 21 days as one cycle. RECIST 1.0 standard was used to evaluate the clinical efficiency, and the WHO toxicity standard was used to evaluate toxic reaction, and the QOL was used to evaluate the quality of life. Results： All patients were given 162 cycles （at least 2 cycles, at most 6 cycles） and the response rate of all the patients were evaluated. There were 2 complete remission （CR）, 7 partial remission （PR）, 22 stable disease （SD） and 19 progressive disease （PD） in the group, the overall response rate was （RR） was 18.0% and disease control rate （DCR） 62.0%. The quality of life improvement rate reaches 58.0%. The major toxic reaction included neutropenia, thrombocytopenia, hypemia, nausea, and vomiting. Most of the severity of these effects was grade I–II and well tolerated. Conclusion： Chemotherapy with pemetrexed or pemetrexed combined with platinum in the treatment of advanced non-small cell lung cancer is effective, safe and well-tolerable, which can improve quality of life of the patient.

Clinical analysis of concurrent chemoradiotherapy in 83 patients with locally advanced non-small cell lung cancer

Objective:The purpose of this study was to evaluate the efficacy and safety of concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LANSCLC). Methods:83 cases of patients who have been diagnosed for locally advanced NSCLC by determined cytology or pathology were divided into two groups randomly, 42 patients in NP group and 41 patients in EP group. All patients accepted thoracic three-dimensional conformal radiotherapy (3D-CRT) and concurrent either NP chemotherapy in NP group or EP chemotherapy in EP group. 3D-CRT were started on day 1 in the first cycle of chemotherapy. Chemotherapy were carried out for 4 cycles, every cycle was 21 days. Thoracic radiotherapy adopted conventional fractionated irradiation with 15 MeV-X ray, a total dose of 60 Gy. Results: In 83 patients were evaluable, there were 5 cases complete regression to be observed, 29 cases had partial regression (PR), 7 cases with stable disease (SD) and 1 case with progression disease (PD) in NP group. CR 3 cases, PR 27 cases, SD 9 cases and PD 2 cases in EP group. The overall response rate (RR) both NP group and EP group were 80.9%, 73.2%, respectively (P = 0.785).1-, 2-, 3-year survival rate were 90.5%, 69.0%, 28.6% and 82.9%, 51.2%, 21.9%, respectively (P = 0.393). The incidence of leukopenia and thrombocytopenia in NP group was higher than that in the EP group (P < 0.05). Conclusion:CCRT in patients with locally advanced non-small cell lung cancer, 3D-CRT with concurrent NP or EP chemotherapy. 1-, 2-, 3-year overall survival (OS) and average survival time (AST) were not statistically differences, a higher incidence of toxicities were observed in NP group but can be tolerable.

Effects of Aidi injection on vinorelbine plus cisplatin chemotherapy for advanced non-small cell lung cancer

Objective： To evaluate the effects of Aidi injection on vinorelbine plus cisplatin （NP） chemotherapy for advanced non-small cell lung cancer （NSCLC）. Methods： Ninety eight patients with advanced NSCLC were randomized to receive either NP alone or NP plus Aidi injection every 3 weeks. The primary endpoint was overall survival; secondary endpoints included overall response rate, time to progression, and safety. Results： The median overall survival time was 11.6 months in NP plus Aidi-treated patients and 10.1 months in NP alone-treated ones, and 1- and 2-year survival rates were higher in the former （47% and 22%） than the latter （42% and 15%）. The overall response rates in Aidi injection plus NP-treated patients tended to be higher but not statistically significant compared with NP alone-treated ones. The occurrence rates of grades 3 or 4 toxicities, e.g. fatigue, nausea, vomiting, appetite loss, leucopenia, thrombocytopenia and anemia, were lower in Aidi injec- tion plus NP-treated patients than NP alone-treated ones, although not significantly different between them. Con^lusion：Aidi injection promotes NP chemotherapeutic effects, reduces the toxicities, and improves the patients＇ tolerance to chemotherapy as well. It may be an effective adjunct to chemotherapy in patients with NSCLC.

A pilot study of weekly docetaxel chemotherapy combined with regional hyperthermia for pretreated stage Ⅲ non-small cell lung cancer

Objective： To evaluate the feasibility and therapeutic effect of chemotherapy combined with regional radio frequency hyperthermia for pretreated locally advanced non-small cell lung cancer. Methods： 29 patients with stage Ⅲb non- small cell lung cancer were enrolled in present study, administered chemotherapy up to 4 cycles and radio frequency hyperthermia up to 32 times. The primary end points were grade 3, 4 hematological or non-hematological toxicities and progression free survival, the secondary end points were response rate, tumor control rate and overall survival. Method of Kaplan-Meier was used to do the survival analysis. Results： 21 patients completed whole treatment. The most common grade 3, 4 toxicity was neutropenia （24.1%）. Median progression free survival was 4 months （range 0-13 months）, one year progression free survival rate was 10.3%, Overall response rate was 25.9%, tumor control rate was 66.6%. Median overall survival was 11 months （range 2-18^＊ months）, one year overall survival rate was 44.8%. Conclusion： Treatment of chemotherapy in conjunction with regional hyperthermia was safe and well tolerant, and it showed an impressive tumor control rate and an acceptable one year progression free survival.

Effects of weekly dose docetaxel monotherapy schedule for elderly patients with non-small cell lung cancer

Objective： To investigate the clinical efficacy and toxicity of weekly dose docetaxel monotherapy schedule in elderly with advanced non-small cell lung cancer （NSCLC）. Methods： 28 patients aged over 65 with advanced NSCLC were received with docetaxel （Aisu） 35 mg/m^2 on days 1, 8 and 15 every 28 days. A clinical evaluation on effectiveness, quality of life and toxicities was performed. Results： 28 patients were given 86 cycles＇ chemotherapy altogether. The overall response rate was 35.7% （10/28）. The clinical beneficial rate was 64.3% （18/28）. Mean KPS was increased from 75.5 at baseline to 87.7 after chemotherapy （P 〈 0.01）; lung cancer symptom scale （LCSS） scores of cough, hemoptysis, chest pain and dyspnea were increased from 64, 65, 62 and 65 to 90, 92, 87 and 88, respectively （P 〈 0.01）. The median time to progression （TTP） was 5.3 months; median survival time （MST） was 8.5 months. The main toxicities were fatigue, leukopenia and decrease of hemoglobin with well tolerance. Conclusion： Weekly dose docetaxel monotherapy schedule is a feasible, well-tolerated, and active scheme in the treatment of the elderly patients with advanced NSCLC.

Clinical study on concurrent and sequential therapy of intensity modulated radiation therapy (IMRT) combined with NP regimen chemotherapy in the treatment of middle and advanced non-small cell lung cancer

Objective: To evaluate the clinical effects of concurrent and sequential therapy for middle and advanced stage non-small cell lung cancer (NSCLC) useing IMRT combined with NP regimen chemotherapy. Methods: Eighty patients with middle and advanced stage NSCLC were randomized into two groups. Forty patients were underwent sequential therapy and other 40 patients were underwent concurrent therapy. IMRT was used in radiotherapy and NP regimen of vinorelbine+cispatin (NP) was used in chemotherapy. Results: (1) The overall response (CR+PR) rate was 75% in concurrent group and 45% in sequential group (P<0.05); (2) The treatment courses were 84 days and 140 days for concurrent group and sequential group respectively (P<0.05); (3) One-year survival rate in concurrent group was 72.4% and 52.3% in sequential group respectively; (4) The toxic effects can be tolerable by all of patients. Conclusion: The concurrent chemo-radiotherapy has better overall re- sponse, one-year survival rate and shorter treatment course than the sequential chemo-radiotherapy, so it is a better method for the treatment of middle and advanced stage NSCLC, but the long term survival rate will be studied.

The Therapeutic Effects of the Radiotherapy Plus TCM Treatment Observed in Senile Non-Parvicellular Lung Cancer Patients at the Late Stage

47 senile non-parvicellular lung cancer patients at stage Ⅲ or Ⅳ were randomly divided into a treatment group (26 cases) treated by radiotherapy plus traditional Chinese medicine (TCM) and a control group (21 cases) treated only by radiotherapy for observation of the therapeutic effects.The patients in the treatment group orally took Chinese medicine during and after the radiotherapy.There was no obvious difference in short-term therapeutic effects between the two groups,but the long-term curative effects in the treatment group was obviously superior to that in the control group (P<0.05 or P<0.01).Conclusion:radiotherapy plus TCM can prolong the survival period for senile non-parvicellular lung cancer patients.

A clinical comparative study of GP and TP 1st-line chemotherapies for advanced non-small cell lung cancer

Objective： The aim of the study was to evaluate the efficacies of initial gemcitabine plus cisplatin （GP） and paclitaxel plus cisplatin （TP） 1st-line chemotherapies for advanced non-small cell lung cancer （NSCLC） and observe their side effects. Methods： Eighty-one cases were randomly divided into two groups： GP group and TP group. In GP group, adminis- tered gemcitabine （GEM） 1000 mg/m2 on days 1 and 8; i.v. cisplatin （DDP） 30 mg/m2 from days 2 to 4 on a 28-day cycle. In TP group, administered paclitaxel （PTX） 175 mg/m2 on day 1, i.v. DDP 30 mg/m2 from days 2 to 4 on a 28-day cycle. Results： GP group had an overall response rate （ORR; CR＋PR） of 45.0% （18/40）. TP had an overall response rate of 43.2% （16/37）. Short-term ORR had no significant difference between two groups （x2 = 0.527, P = 0.957）. GP had median survival time of 11 months and 37.7% of one-year survival rate, while TP showed 11 months of median survival time and 31.7% of one-year survival rate. Survival had no significant difference between two groups （x2 = 0.140, P = 0.708）. However, main side effects varied. Thrombocytopenia of GP group was significantly more than that of TP group, while peripheral neuritis, nausea/vomiting and myalgia of TP group were significantly more than those of GP group. Conclusion： Both GP and TP regimens had no significant difference in short-term treatment effect and survival rate for initial treatment of advanced NSCLC. However, side effects related to GP regimen treatment were slighter. Therefore, it was considered as the preferred initial first-line treatment for NSCLC.