摘要
目的探索非小细胞肺癌(NSCLC)高效、低毒副反应的化疗模式。方法126例晚期(TNM分期为Ⅲ、Ⅳ期)NSCLC随机分为两组(1)高剂量冲击式(高冲式)化疗组54例紫杉醇135～175mg/m2静滴,第1天;顺铂80～100mg/m2静滴,第1天;有脑转移者加卡莫司汀125mg静滴,第1～3天。间隔4～6周。(2)低剂量密集式(低密式)化疗组72例紫杉醇60～80mg/m2静滴,第1天;顺铂40～60mg/m2静滴,第1天;有脑转移者加卡莫司汀125mg静滴,第1天。每周化疗1次,连续4～6周,间隔2周。高冲式化疗者常规用止吐药及水化处理;低密式化疗者酌情用止吐药,无需水化。结果高冲式化疗组共治疗157个疗程,CR3例,PR23例,SD17例,PD11例,有效缓解率48.1%,中位缓解期4.5个月,1年生存率46.3%。低密式化疗组共治疗184个疗程,CR9例,PR30例,SD24例,PD9例,有效缓解率54.2%,中位缓解期6.0个月,1年生存率56.9%。低密式化疗组有效缓解率和1年生存率均高于高冲式化疗组,但差异无显著性(P>0.05);重度(Ⅲ+Ⅳ度)毒副反应率亦低于高冲式化疗组。高冲式化疗组发生与化疗相关死亡2例(3.7%)。低密式化疗组化疗后患者生活质量上升的比例(70.8%)高于高冲式化疗组(51.9%),差异有显著性(P<0.05)。结论低剂量密集式化疗采用低剂量、短间歇期、频投药的方法,提高了剂量强度,化疗效果好,毒副?
Objective To explore high effective and low toxic chemotherapeutic regimens in the treatment of non small cell lung cancer (NSCLC). Methods A total of 126 patients with advanced NSCLC (Stage Ⅲ,Ⅳ) were randomly divided into two groups: high dose impulsion chemotherapy group (HDIC group) and low dose density chemotherapy group (LDDC group) with 54 patients in HDIC group who received paclitaxel 135 175 mg/m 2 on day 1, DDP 80 100 mg/m 2 on day 1 and BCNU 125 mg given for brain metastasis on days 1 3 in a 4 6 weeks cycle. Seventy two patients in LDDC group were given paclitaxel 60 80 mg/m 2 on day 1, DDP 40 80 mg/m 2 on day 1 repeated weekly and BCNU 125 mg given for brain metastasis with an interval of 2 weeks, in a 4 6 weeks cycle. Antiemetic agent and fluid were administered routinely in HDIC group whereas LDDC group was given antiemetic agent only. Results Of 157 courses in HDIC group, an average of 2.9 courses per patient, CR 3, PR 23, SD 17 and PD 11 were observed. The effective remission rate was 48.1%, the median effective remission period was 4.5 months and the 1 year survival rate was 46.3%. Of 184 courses in LDDC group, an average of 2.6 courses per patient, CR 9, PR 30, SD 24 and PD 9 were observed. The effective remission rate was 54.2%, the median effective remission period was 6 months and the 1 year survival rate was 56.9%. The effective remission rate and the 1 year survival rate were higher in HDIC group than those in LDDC group, but there was no statistical difference between the two groups ( P >0.05). Severe toxicity was higher in HDIC group than in LDDC group. Two patients in HDIC group died of treatment related complications (3.7%). Quality of life was better in LDDC group (70.8%) than in HDIC group (51.9%). Conclusion When comparing with high dose impulsion, low dose density regimen of paclitaxel plus cisplatin is more effective and better tolerated with improvement of quality of patients′ life in the treatment of NSCLC due to its low dose and short interval duration.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2004年第10期621-625,共5页
Chinese Journal of Oncology
关键词
化疗
静滴
低剂量
顺铂
高剂量
缓解率
治疗
结论
显著性
探索
Lung neoplasms/drug therapy
Carcinoma,non small cell lung/drug therapy
Paclitaxel/therapeutic use
Cisplatin/therapeutic use
