Adjuvant Chemotherapy of Gemcitabine plus Carboplatin versus Paclitaxel plus Carboplatin in Patients with Resected Non-Small Cell Lung Cancer

Background: This retrospective study was to evaluate the efficacy and toxicity of gemcitabine plus carboplatin (GC regimen) and paclitaxel plus carboplatin (PC regimen) combination chemotherapy administered as an adjuvant therapy after complete resection of non-small cell lung cancer. Methods: Forty-four patients (GC regimen, n = 29;PC regimen, n = 15) received gemcitabine at a dose of 1000 mg/m2 on days 1 and 8, and carboplatin with the target dose of area under the curve (AUC) of 4 on day 8 every 28 days and paclitaxel at a dose of 70 mg/m2 on days 1, 8 and 15, and carboplatin with the target dose of AUC of 5 on day 1 every 28 days. Results: A total of 130 cycles of the treatment were administered (averaged, 3.1 in GC arm and 2.7 cycles in PC arm). Forty-three patients (97.7%) completed the scheduled cycles. One patient (2.3%) was discontinued due to grade 4 pneumonia. The dose was reduced in 2 patients (4.5%) due to grade 4 thrombocytopenia. Grade 3/4 neutropenia was significantly observed in the PC group (GC: 12/29, 41.4%;PC: 11/15, 73.3%, p = 0.0443). The nonhematological toxicities were mild. Grade 1/2 alanine aminotransferase and aspartate aminotransferase in the GC group was significantly observed higher compared to those of the PC group (GC: 20/29, 69.0%;PC: 4/15, 26.7%, p = 0.0076). Grade 1/2 alopecia was significantly observed in the PC group (GC: 0/25, 0.0%;PC: 13/15, 86.7%, p 0.0001). There was no treatment-related death. The median survival time (MST) of the entire GC group was 784 days, the 3-year overall survival (OS) was 75.9%, and 3-year recurrence-free survival (RFS) was 65.5%. The MST of the entire PC group was 963 days, the 3-year OS was 80.0%, and the 3-year RFS was 60.0%. Conclusion: These results demonstrate that the GC and PC combination chemotherapies are efficacious and feasible regimens, which should be considered as one of the standard therapies for adjuvant therapy.

Effect of intensity modulated radiation therapy combined with paclitaxel+ endostar chemotherapy on serum malignant molecule levels in patients with locally advanced non-small cell lung cancer

Objective: To discuss the effect of intensity modulated radiation therapy combined with paclitaxel + endostar chemotherapy on serum malignant molecule levels in patients with locally advanced non-small cell lung cancer. Methods: Patients with locally advanced NSCLC who were treated in the hospital between February 2015 and January 2017 were collected and divided into control group (n=59) and research group (n=59) by random number table. Control group received the routine paclitaxel + endostar chemotherapy after the operation, and research group underwent intensity modulated radiation therapy combined with paclitaxel +endostar chemotherapy after the operation. The differences in serum levels of NSCLC-related tumor markers and angiogenesis indexes were compared between the two groups before and after treatment. Results: Before treatment, the differences in serum levels of NSCLC-related tumor markers and angiogenesis indexes were not statistically significant between the two groups. After treatment, serum TK1, CYFRA21-1, Pro-GRP, CEA, CA125 and SCC-Ag levels of research group were lower than those of control group;serum EGFR, COX-2, VEGF, HIF-1 and MMP-2 levels of research group were lower than those of control group. Conclusion:Postoperative intensity modulated radiation therapy combined with paclitaxel + endostar chemotherapy can effectively reduce the serum malignant molecule levels and optimize the illness in patients with local advanced NSCLC.

Advances in the Treatment of Advanced Non-Small Cell Lung Cancer

In recent years, the incidence of lung adenocarcinoma has been increasing, and now it has become the largest type of non-small cell lung cancer (NSCLC). Currently, treatment of advanced NSCLC consists of several modalities: systemic chemotherapy, local radiation therapy, and targeted therapy (including most recently immunotherapy). In the past decade, the discovery of new molecular subtypes, the search for tumor driver gene mutations, the development of targeted molecular targeted drugs, or targeted therapy to suppress tumor angiogenesis and regulate tumor immune response have been the main directions of NSCLC research and clinical diagnosis and treatment. At present, platinum-based chemotherapy is widely used in NSCLC patients clinically. Platinum-based chemotherapy drugs can effectively prolong the survival time of patients and improve their quality of life, but the incidence of adverse reactions is still high. Therefore, it is necessary to find a drug that can improve the efficacy of patients and reduce the adverse reactions of platinum chemotherapy drugs to NSCLC patients.

Radiofrequency deep hyperthermia combined with chemotherapy in the treatment of advanced non-small cell lung cancer

Background:In the era of precision medicine,chemotherapy is still considered the cornerstone of treatment for lung cancer patients without gene mutations.How to reduce the toxicity and increase the efficiency of chemotherapy is worth exploring.This study aimed to investigate the curative effects and safety of hyperthermia combined with chemotherapy(HCT)for advanced patients with non-small cell lung cancer(NSCLC),especially those with malignant pleural effusion.Methods:We retrospectively evaluated medical records of 93 patients with advanced NSCLC(stage IIIB-IV)from March 2011 to January 2014.The patients were divided into HCT and chemotherapy(CT)groups.The HCT group was treated with gemcitabine and cisplatin(GP)regimen combined with regional radiofrequency deep hyperthermia,while the CT group was treated with GP regimen only.Those with malignant pleural effusion extra underwent thoracentesis and intrapleural injection chemotherapy combined with hyperthermic or not.Clinical treatment results and adverse reactions were compared and analyzed after treatment.SPSS 19.0 software(SPSS Inc.,USA)was used for statistical data processing.P values less than 0.05 were accepted to be statistically significant.Results:Among the 93 patients,HCT group included 48 patients(16 patients with malignant pleural effusion),CT group included 45 patients(10 patients with malignant pleural effusion).There was no significant difference between the two groups in patient characteristics.The overall response rate(ORR)of pleural effusions was much better in HCT group than that in CT group(81.2%vs.40.0%,P=0.046).The patients in HCT group had lower incidence rate of weakness(12.5%us.46.7%,χ^2=13.16,P<0.001)and gastrointestinal(25.0%vs.77.8%,χ^2=25.88,P<0.001)adverse reactions than that in CT group.The objective tumor response and survival showed no significant differences.Conclusions:Hyperthermia combined with chemotherapy might lead to the development of better therapeutic strategy for advanced NSCLC with malignant pleural effusion patients.Also,it could greatly reduce the chemotherapy toxic effects in the incidence of weakness and gastrointestinal adverse reactions in advanced NSCLC patients.

Epidermal growth factor receptor genotype in plasma DNA and outcome of chemotherapy in the Chinese patients with advanced non-small cell lung cancer

Background The genotype of epidermal growth factor receptor （EGFR） is associated with tyrosine kinase inhibitor and effectiveness of therapy, but its role in cytotoxic chemotherapy is still unknown. Previous studies indicated that certain EGFR mutations were associated with response and progression free survival following platinum based chemotherapy. Our recent studies have identified that EGFR genotypes in the tumour tissues were not associated with response to the first-line chemotherapy in Chinese patients with advanced non-small cell lung cancer （NSCLC）. In this study, we investigated associations of EGFR genotypes from plasma of patients with advanced NSCLC and response to first-line chemotherapy and prognosis. Methods We enrolled 145 advanced NSCLC patients who had received first-line chemotherapy in our department. We examined plasma EGFR genotypes for these patients and associations of EGFR mutations with response to chemotherapy and clinical outcomes. Results There were 54 patients with known EGFR mutations and 91 cases of wild types. No significant difference was detected in the response rate to first-line chemotherapy between mutation carriers and wild-type patients （37.0% vs. 31.9%）. The median survival time and 1-, 2-year survival rates were higher in mutation carriers than wild-types （24 months vs. 18 months, 85.7% vs. 65.7% and 43.7% vs. 25.9%, P=0.047）. Clinical stage （Ⅳvs. Ⅲb）, response to the first-line chemotherapy （partial vs. no） and EGFR genotype were independent prognostic factors. Conclusion Plasma EGFR mutations in the Chinese patients with advanced NSCLC is not a predictor for the response to first-line chemotherapy, but an independent prognostic factor indicating longer survival.

Role of Recursive Partitioning Analysis and Graded Prognostic Assessment on Identifying Non-Small Cell Lung Cancer Patients with Brain Metastases Who May Benefit from Postradiation Systemic Therapy

Background：The role ofpostradiation systemic therapy in non-small cell lung cancer （NSCLC） patients with brain metastasis （BM） was controversial.Thus,we explored the role of Radiation Therapy Oncology Group recursive partitioning analysis （RTOG-RPA） and graded prognostic assessment （GPA） in identifying population who may benefit from postradiation systemic therapy.Methods：The clinical data of NSCLC patients with documented BM from August 2007 to April 2015 of two hospitals were studied retrospectively.Cox regression was used for multivariate analysis.Survival of patients with or without postradiation systemic therapy was compared in subgroups stratified according to RTOG-RPA or GPA.Results：Of 216 included patients,67.1% received stereotactic radiosurgery （SRS）,24.1% received whole-brain radiation therapy （WBRT）,and 8.8% received both.After radiotherapy,systemic therapy was administered in 58.3% of patients.Multivariate analysis found that postradiation systemic therapy （yes vs.no） （hazard ratio [HR] =0.36 l,95% confidence interval [CI] =0.202-0.648,P =0.001）,radiation technique （SRS vs.WBRT） （HR =0.462,95% CI =0.238-0.849,P =0.022）,extracranial metastasis （yes vs.no） （HR =3.970,95% CI =1.757-8.970,P =0.001）,and Kamofsky performance status （〈70 vs.≥70） （HR =5.338,95% CI =2.829-10.072,P 〈 0.001） were independent factors for survival.Further analysis found that subsequent tyrosine kinase inhibitor （TKI） therapy could significantly reduce the risk of mortality of patients in RTOG-RPA Class IⅡ （HR =0.411,95% CI =0.183-）.923,P =0.031） or with a GPA score of 1.5-2.5 （HR =0.420,95% CI =0.182-0.968,P =0.042）.However,none of the subgroups stratified according to RTOG-RPA or GPA benefited from the additional conventional chemotherapy.Conclusion：RTOG-RPA and GPA may be useful to identify beneficial populations in NSCLC patients with BM ifTKIs were chosen as postradiation systemic therapy.

Maintenance therapy in advanced non-small cell lung cancer： a prime-time for change？

Lung cancer is the leading cancer in terms of incidence and mortality in China and its incidence in China is predicted to increase in the next 20 years.1 The majority of the lung cancer patients are diagnosed with advanced stage disease,for which chemotherapy or targeted therapies are the mainstay palliative treatments.Before the identification of single-driver mutations,like the epidermal growth factor receptor （EGFR） mutation,platinum-based doublet was the standard first line treatment for advanced stage nonsmall cell lung cancer （NSCLC） patients with a good performance status （PS）.However,patient prognosis remains poor and the modest treatment efficacy seems to have reached a plateau despite newer generation of platinum doublets.2 The recommendation for the duration of first line platinum doublet treatment is 4-6 cycles.3 The paradigm was based on the fact that a protracted course of chemotherapy did not prolong survival but introduced cumulative toxicities.4,5 The use of maintenance therapy （MT）,defined by Grossi et al6 as the prolongation of chemotherapy with the administration of additional drugs at the end of a defined number of initial chemotherapy cycles after achieving maximum tumor response,was not considered as a standard option in the past.

Prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer

Background The prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer （NSCLC） remains unclear.This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.Methods The data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed.There were 41 patients in the surgery group （S）,21 in the postoperative radiotherapy （PORT） group （S＋R）,30 in the postoperative chemotherapy （POCT） group （S＋C）,and 32 in the PORT plus POCT group （S＋R＋C）.The constitute proportion in different groups was tested using the X2 method,univariate analysis was performed using the Kaplan-Meier and log-rank method,and multivariate analysis was done using the Cox hazard regression with entry factors including age,sex,pathological type and stage,classification of the residual disease,and treatment procedure.The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.Results In univariate analysis,survival was more favorable for patients with squamous cell carcinoma,early pathological T or N stage,and chemotherapy or radiotherapy.There was no significant difference in the survival for patients with different types of the residual disease,except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa （P=0.030）.The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone （P=0.016）.In multivariate analysis,the pathological type （HR 2.51,95% CI 1.59 to 3.96,P=0.000）,pathological T （HR 1.29,95% CI 1.04 to 1.60,P=-0.021） or N stage （HR 2.04,95% CI 1.40 to 2.98,P=0.000）,and chemotherapy （HR 0.24,95% CI 0.13 to 0.43,P=0.000） were independent prognostic factors.Conclusion Patients with squamous cell carcinoma,early pathological T or N stage,or receiving chemotherapy had a more favorable prognosis.

Tolerability and toxicity of adjuvant cisplatin and gemcitabine for treating non-small cell lung cancer

Background The combination of cisplatin and vinorelbine is an evidence-supported regimen for adjuvant chemotherapy for treating non-small cell lung cancer （NSCLC）. But this doublet has considerable toxicity and unfavorable tolerability, and results in poor compliance. The cisplatin and gemcitabine regimen is one of the most active and well-tolerated regimens against advanced NSCLC, but its toxicity and tolerability has not been adequately evaluated in the adjuvant setting. Methods From a lung cancer database we retrospectively reviewed NSCLC patients receiving adjuvant chemotherapy of cisplatin （75 mg/m2） and gemcitabine （1250 mg/m2） between January 2005 and December 2011. Postoperative demographics, compliance to adjuvant therapy and toxicity were retrieved from medical records. Results A total of 132 patients met the criteria and were included in the study, 96 were male （72.7%） and 36 were female （27.3%）. Median age was 60.5 years old, range 29-75 years, and 41.7% of patients were 〉65 years old. Overall, 68.2% patients received all four planned cycles, and the cumulative dose delivered for gemcitabine was 8333 mg （83.3% of the planned dose） and cisplatin 248 mg （82.7% of the planned dose）. There were no treatment-related deaths. Grade 3/4 neutropenia developed in 47 patients （35.6%） and was the predominant hematologic toxicity. Common grade 3/4 non- hematologic toxicities were nausea/vomiting （22.0%）, infection （12.3%）, and febrile neutropenia （11.4%）. Conclusion Cisplatin and gemcitabine are feasible for use in the adjuvant setting with a favorable toxicity profile and superior tolerabilitv compared with Dublished data on cisDlatin and vinorelbine.

Clinical benefit of gemcitabine plus cisplatin 3-week regimen for patients with advanced non-small cell lung cancer: a prospective observational study

Background Platinum-based chemotherapy has been proved effective in patients with advanced non-small cell lung cancer (NSCLC). This study evaluated the effectiveness and safety of first-line chemotherapy with gemcitabine plus cisplatin (GEM-Cis) 3-week regimen in routine care of Chinese patients with advanced NSCLC. Methods Two hundred and twenty-one patients with NSCLC stage IIIb or IV were enrolled and 209 were eligible for effectiveness and safety analysis. The median age was 58 (range 29 to 79) years. The percents of cases in stage Ⅳ and stage Ⅲb were 52.2% and 47.8%; of Karnofsky performance score (KPS) less than 80 and 80-100 were 37.3% and 62.7% and of adeno-cancer and non-adeno-cancer were 59.8% and 40.2%. The average number of completed chemotherapy cycles was three. Measures of effectiveness included clinical benefit, significant clinical response (SCR) and adverse effects of GEM-Cis in the treatment of NSCLC at stages Ⅲb/Ⅳ.Results KPS increased from 79±9 at baseline to 86±10 after chemotherapy (P<0.01). Lung cancer symptom scale (LCSS) score of pain, dyspnea and cough increased from 77±24, 74±22 and 63±19 to 92±15, 90±14 and 86± 15, respectively (P<0.01). The clinical benefit rate was 85.2% [95% confidence interval (CI) 80.3%-90.0%]. The SCR was 89.5% (95% CI 85.3%-93.7%). Median survival time was 7.8 months (95% CI 7.1 months-9.1 months). Sixty-four patients (30.6%) experienced an adverse effect that was deemed clinically significant. Only one patient (0.5%) was hospitalized due to chemotherapy related adverse effects. Life-threatening toxicity was observed in two patients (1.0%).Conclusion First-line chemotherapy with GEM-Cis in the routine care of Chinese patients with advanced NSCLC is effective and safe.

Non-small cell lung cancer-small cell lung cancer transformation as mechanism of resistance to tyrosine kinase inhibitors in lung cancer

Mutated or rearranged driver kinases in non-small cell lung cancer(NSCLC)cells are clinically amenable to treatment with tyrosine kinase inhibitors(TKIs)resulting in prolonged survival and significant benefit compared to cytotoxic chemotherapy.The most frequent genomic alterations are observed for epidermal growth factor receptor and anaplastic lymphoma kinase,which can be blocked by a range of specific TKIs in sequence.In clinics,resistance to TKIs emerges after approximately one year and comprises secondary mutations of the kinases(on-target)or alternative pathways circumventing the original kinase(off-target)alterations.A special feature of NSCLC is the occurrence of histological transformation to small cell lung cancer(SCLC)in up to 14%of cases,which,in general,is accompanied by resistance to the original TKIs.SCLC transformed tumors may be treated with the classical platinum/etoposide regimen but thus far there are no definitive guidelines.Four transformed pleural SCLC lines in our lab indicate the presence of a gradual NSCLC-SCLC shift with overlapping drug sensitivities.In conclusion,the treatment of NSCLC-SCLC transformed cancer cells would need a better chemosensitivity assessment using functional genomics to guide further therapy.

小细胞肺癌内科治疗新进展

小细胞肺癌(small cell lung cancer,SCLC)具有极高的增殖率、较强的早期转移倾向和较差的预后。超过三分之二的患者初诊时分期为广泛期(extensive stage-small cell lung cancer,ES-SCLC)。小细胞肺癌治疗进展缓慢,含铂化疗一直是标准治疗方案,虽然近期有效率高,但易出现耐药。近年来免疫治疗及抗血管药物的兴起,在SCLC领域出现了突破,为SCLC建立新的治疗标准。本文将SCLC的化学治疗、抗血管治疗及免疫治疗进展进行综述。

Emerging insights to lung cancer drug resistance

Lung cancer remains the malignant tumor with the highest morbidity and mortality in China,with non-small cell lung cancer(NSCLC)accounting for 80%-85% of cases.Nowadays,the treatment pattern of NSCLC has evolved toward precision management with the development of molecular targeted therapy and immunotherapy.However,the median overall survival for patients with metastatic NSCLC,unfortunately,remains less than three years.Drug resistance is the bottleneck to preventing drugs from playing a further role,and the mechanistic study of drug resistance is the prerequisite for new regimen development.This Special Issue pays special attention to drug resistance in the treatment of NSCLC.We received and published several excellent articles regarding this topic.We hope that,through this Special Issue,we can have a deep understanding of the existing problems,the underlying mechanism,and the future solutions and that the publication of this Special Issue can bring some inspiration to readers.

香菇多糖联合化疗治疗晚期非小细胞肺癌

背景与目的 香菇多糖作为一种生物免疫调节剂日益受到药学界与临床的广泛重视，目前中国和日本都将其作为一种抗肿瘤辅助药品广泛应用。本研究旨在观察香菇多糖联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的治疗效果。方法 81例Ⅲ、Ⅳ期非小细胞肺癌患者随机分为A、B两组，A组（42例）采用香菇多糖加化疗，B组（39例）采用单纯化疗。两组患者在治疗前后测定外周血T淋巴细胞亚群（CD3、CD4、CD4／CDR）和NK细胞活性，并以正常人（30例）作为对照，对患者疗效、免疫功能、生活质量及不良反应进行评价。结果 治疗后A、B两组的有效率分别为50％和33％（P＜0．05）；A组的T淋巴细胞亚群和NK细胞活性明显高于治疗前（P＜0．01），CDR明显低于治疗前（P＜0．05），而B组无明显变化（P〉0．05）；A组的Karnofsky评分上升率（52％）高于B组（23％）（P〈0．01）；B组的Ⅱ～Ⅳ度白细胞减少及恶心呕吐反应发生率（分别为51和44例次）高于A组（分别为39和24例次）（P＜0．05）。结论香菇多糖联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的疗效优于单纯化疗。

GP方案治疗50例晚期非小细胞肺癌的疗效观察

目的 观察GP方案治疗晚期非小细胞肺癌 (NSCLC)的近期疗效及毒副反应。方法 5 0例晚期非小细胞肺癌患者采用GP方案 :吉西他滨 (GEM) 10 0 0mg m2 ,静脉注射 ,3 0～ 60min ,第 1,8天 ;顺铂 (DDP) 80mg m2 ,静脉滴注 ,2h ,第1天 ,2 1d为 1周期。结果 GP方案治疗非小细胞肺癌总有效率 5 6 0 % ,其中CR 1例 ( 2 0 % ) ,PR 2 7例 ( 5 4 0 % ) ,SD 16例( 3 2 0 % ) ,PD 6例 ( 12 0 % ) ,19例初治者和 3 1例复治者近期有效率分别为 63 1%和 5 1 6% ,中位生存期 8 5个月 ( 4～ 18个月 ) ,1年生存率为 3 2 2 %。主要毒副反应为中度骨髓抑制和胃肠道反应。结论 GP治疗方案对晚期非小细胞肺癌有较好的疗效且用药安全。

同步放化疗与序贯放化疗治疗局部晚期非小细胞肺癌的疗效比较

目的：比较同步放化疗与序贯放化疗治疗局部晚期非小细胞肺癌（NSCLC）的疗效和安全性。方法：268例局部晚期NSCLC患者随机分为同步组和序贯组,同步组采用多西他赛＋顺铂化疗,并化疗第1天开始同步采用三维适形或调强放疗,同步2周期。序贯组采用多西他赛＋顺铂化疗2周期后,采用三维适形或调强放疗,放疗结束后两组均再化疗2个周期。比较两组的近期疗效、生活质量和药品不良反应。结果：同步组总缓解率为73.13%,序贯组为50.75%,两组差异有统计学意义（P〈0.05）。同步组生活质量提高率为22.39%,明显高于序贯组的11.94%（P〈0.05）。两组Ⅲ~Ⅳ级放射性肺炎、Ⅲ~Ⅳ级放射性食管炎、Ⅲ~Ⅳ级骨髓抑制和Ⅲ~Ⅳ级胃肠道反应发生率比较,差异均无统计学意义（P〉0.05）。结论：同步放化疗能明显增强局部晚期NSCLC的治疗效果,提高生活质量,并未明显增加不良反应风险。

香菇多糖联合吉西他滨与顺铂治疗非小细胞肺癌效果

目的探讨应用香菇多糖联合吉西他滨与顺铂治疗晚期非小细胞肺癌（NSCLC）的效果。方法对98例经病理或细胞学检查证实的晚期NSCLC的初治病人给予联合化疗，随机分为香菇多糖、吉西他滨和顺铂（GPL）组与吉西他滨和顺铂（GP）组。GP组吉西他滨1000mg／m^2静脉注射，第1、8天，顺铂25mg／m^2加入生理盐水250mL中静滴，第1～3天；21d为1个周期，每例治疗不超过6个周期。GPL组在GP组治疗的基础上，将香菇多糖1mg加入50g／L的葡萄糖注射液250mL中静滴，每周2次，连用8周，并比较两组疗效。结果两组有效率、1年生存率、中位生存期比较差异无显著性。最常见的毒副作用为恶心呕吐，GPL和GP组的Ⅲ＋Ⅳ度反应发生率分别为4．08％和55．10％，两组比较差异有显著性（χ^2=30．620，P〈0．05）；其余毒副作用轻微，可耐受。结论香菇多糖联合吉西他滨与顺铂治疗晚期NSCLC与单纯化疗相比疗效相似，而毒副作用轻，安全可行，值得临床推广应用。

三维适形放疗联合紫杉醇单药每周化学治疗老年非小细胞肺癌的疗效观察

目的探讨三维适形放疗联合紫杉醇单药每周化疗治疗老年非小细胞肺癌的临床疗效。方法将88例非小细胞肺癌患者根据治疗方法随机分为2组,分别行三维适形放疗及联合紫杉醇单药化疗。结果观察组患者治疗后的近期有效率显著高于对照组(P<0.05)。观察组1年局控率、转移率与对照组差异较为显著(P<0.05),但2组患者2年局控率、转移率以及1年与2年的生存率相比差异不显著(P>0.05)。观察组患者中位生存时间相比对照组显著延长(P<0.05),血液毒性发生率相比对照组明显升高(P<0.05)。结论三维适形放疗联合每周紫杉醇单药化疗能够有效治疗老年非小细胞肺癌,能够有效改善近期疗效,延长患者生存期,但不良反应较高。

非小细胞肺癌的药物治疗策略

本文介绍非小细胞肺癌的药物治疗策略的新进展,包括术前化疗,术后化疗,不可手术患者和老年患者的化疗问题,以及化疗联合分子靶向治疗等内容,为更合理的进行个体化治疗提供理论依据。

得力生联合化疗治疗晚期非小细胞肺癌

目的观察广谱中药抗癌药得力生联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的治疗效果和毒副反应。方法60例Ⅲ、Ⅳ期非小细胞肺癌患者随机分为A、B两组,A组采用得力生加GP方案化疗,B组采用单纯GP方案化疗。两组患者在治疗前后测定外周血T淋巴细胞亚群和NK细胞活性,评价患者疗效、免疫功能、生活质量及不良反应,并检测外周血血管内皮生长因子水平。结果治疗后A、B两组的有效率分别为50%和33%(P<0.05);A组的T淋巴细胞亚群和NK细胞活性明显高于治疗前(P<0.01),而B组无明显变化(P>0.05);A组的Karnofsky评分上升率(53%)高于B组(33%)(P<0.01);两组治疗后生存质量有显著性差异;A组的不良反应发生率低于对照组,且发生的程度较轻。结论得力生联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的疗效优于单纯化疗,能增强机体免疫功能,改善患者的生存质量,且不增加骨髓抑制。