摘要
目的:比较健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的疗效和不良反应,分析50例患者的生存及影响因素。方法:50例入选患者均为经病理和细胞学证实的初治晚期非小细胞肺癌,临床上有可测量病灶,摘要目的:比较健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的疗效和不良反应,分析50例患者的生KPS≥80分,肝肾功能基本正常。3周方案:GEM1250mg/m2,d1、8,DDP75mg/m2,d1,每21天为一周期。4周方案:GEM1000mg/m2,d1、8、15,DDP75mg/m2,d1,每28天为一周期。结果:50例患者总有效率30.0%(15/50),其中4周方案有效率27.3%(6/22),3周方案有效率32.1%(9/28),(P>0.05);生存期:50例患者中位生存期为9.3个月(2.1-38.8),其中4周方案11.7个月,3周方案8.9个月。中位TTP4.1个月(1.2-24.0),其中4周方案3.3个月,3周方案4.2个月,差异均无显著性意义(P>0.05);应用COX回归分析显示一线化疗疗效及后继治疗可明显影响患者生存期,化疗方案为3患者生存(周或4周对患者生存的影响差异无显著性意义,后继治疗中含靶向治疗较不含靶向治疗及最佳支持治疗明显改善结论:健择顺铂方案治疗晚期NSCLC有较佳疗效,3周方案与4周方案的疗效相似,以3周方案副反应较少,后继治P=0.000);主要不良反应是白细胞、中性粒细胞、血小板和血红蛋白减少等,两组间的反应无显著差异。疗应用酪氨酸激酶抑制剂亦有可能改善患者生存期。
Objective： To compare the efficacy and safety between 3-week schedule and 4-week schedule of gemcitabine plus cisplatin in the treatment of advanced non-small-cell lung cancer （NSCLC） and to evaluate the survival data of the 50 patients. Methods： A total of 50 chemonaive NSCLC patients of stage Ⅲ B-Ⅳ, KPS≥ 80, measurable lesions and good liver and renal function were enrolled. Three-week schedule was given with Gemcitabine （GEM 1250 mg/M2） on day I and day 8 plus Cisplatin （DDP 75mg/m2） on day Ⅰ. The cycle was repeated every 21 days. Four-week schedule was given with Gemcitabine （GEM 1000 mg/m2） on day Ⅰ, day 8 and day 15 plus Cisplatin （DDP 75 mg/m2） on day Ⅰ. The cycle was repeated every 28 days. Results： The overall response rate was 30.0% （15/50） in all of the 50 patients, 27.3% （6/22） in the 4-week schedule group and 32.1% （9/28） in the 3-week schedule group, with no significant difference （P〉0.05）. The mean survival time was 8.9 months in the 3-week schedule group and 11.7 in the 4-week schedule group （P〉0.05）. The TTP was 4.2 months in the 3-week schedule group and 3.3 months in the 4-week schedule group （P〉0.05）. Cox regression analysis indicated that the efficacy of first-line chemotherapy and the following therapy significantly influenced patient survival. No significant difference was found in patient survival between the 3-week and 4-week schedule. Targeted therapy included in the following therapy significantly influenced the patient sur- vival （P=0.000）. The main side effects included leucocytopenia, granulocytopenia, thrombocytopenia, anorexia and nausea, with no significant difference between the 3-week schedule group and the 4-week schedule group. Conclusion： The combination of Gemcitabine and Cisplatin is an effective regimen in the treatment of advanced non-small-cell lung cancer. The 3-week schedule and the 4-week schedule have similar efficacy. The 3-week schedule cause less side effects than the 4-week schedule. The EG
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2008年第17期991-994,共4页
Chinese Journal of Clinical Oncology
