摘要
背景与目的：目前临床上广泛应用多西紫杉醇联合顺铂作为晚期非小细胞肺癌（NSCLC）的一线化疗方案,但传统3周方案毒副反应较大。因此本研究为比较多西紫杉醇联合顺铂改进的3周方案与传统3周方案一线治疗晚期NSCLC的疗效及毒副反应。方法：68例经组织学或细胞学确诊的ⅢB或Ⅳ期NSCLC患者,随机分为两组分别接受改进方案（A组）和传统3周方案（B组）化疗。A组：多西紫杉醇总剂量按75 mg/m^2,分两次分别于第1、8天,静脉滴注顺铂25 mg/（m^2.d）,静脉滴注,第1天~第3天,每3周重复;B组：多西紫杉醇75 mg/m^2,静脉滴注,第1天,顺铂用法同A组,每3周重复。2周期后评价疗效与毒副反应,并随访1年生存率。结果：两组均无CR,A组PR 10例,SD 20例,PD 4例,总有效率为29%;B组PR 11例,SD 20例,PD 3例,总有效率为32%;A组1年生存率为38%,B组1年生存率为35%,两组疗效（P=0.793）及1年生存率（P=0.801）差异无显著性。中性粒细胞Ⅲ/Ⅳ度减少A组18%;B组47%,两组差异有显著性（P=0.010）。结论：多西紫杉醇联合顺铂改进的3周方案一线治疗NSCLC与传统3周方案相比,疗效相似,但血液学毒性明显下降,耐受性好。
Background and purpose： Docetaxel/cisplatin are widely used in chemo-naive patients with advanced non-small cell lung cancer（ NSCLC）, but the standard 3-weeks＇ project of docetaxel caused significant toxicity. We performed this study to compare the effect and toxicity of modified and standard 3-weeks＇ docetaxel/cisplatin as first line chemotherapy for advanced NSCLC. Methods： 68 patients with stage ⅢB or Ⅳ NSCLC （proven by histology or cytology） were randomly divided into two groups, modified （A） and standard （B） chemotherapy. Group A： docetaxel 75 mg/m^2, divided into 2 days, ivgtt d1 and d 8, cisplatin 25 mg/（ m^2. d）, ivgtt d 1-d 3, q3w; Group B： docetaxel 75 mg/m^2, ivgtt d 1, cisplatin was administered as Group A, q3w. The effect and toxicity were assessed after two cycles and one-year survival was followed up. Results： There was no CR in both groups. 10 PR, 20 SD, 4 PD were found in group A, the overall response rate is 29% ; whereas 11 PR, 20 SD, 3 PD were found in group B, the overall response rate is 32%. The one-year survival rate were 38% and 35% in group A and B, respectively. There were no significant difference about the overall response rate （ P = 0. 793） and one-year survival rate （ P = 0.801） between group A and B. The rates of grade Ⅲ/Ⅳ neutropenia were 18% and 47% in group A and B respectively. The difference was statistically significant （P =0. 010）. Conclusions： In comparison with the standard 3-weeks＇ docetaxel/cisplatin chemotherapy, the modified one has similar response rate but lower hematologic toxicity, and thus it was well tolerated.
出处
《中国癌症杂志》
CAS
CSCD
2007年第7期569-571,共3页
China Oncology
关键词
非小细胞肺癌
多西紫杉醇
顺铂
一线治疗
non-small cell lung cancer, NSCLC
docetaxel
cisplatin
first-line chemotherapy
