摘要
目的观察脂质体紫杉醇联合顺铂对比白蛋白结合型紫杉醇联合顺铂一线治疗晚期非小细胞肺癌(NSCLC)的临床疗效及预后,同时评价血清乳酸脱氢酶(LDH)在预后的评价的作用。方法 62例经病理学证实为晚期的NSCLC患者,按随机数字表法分为白蛋白结合型紫杉醇联合顺铂组(A组,31例)和脂质体紫杉醇联合顺铂组(B组,31例)。分析2组的疗效、不良反应及远期生存。测定血清乳酸脱氢酶(LDH),并根据化疗后血清LDH变化,分为反应组(下降)和不反应组(升高或持平)。结果 A组和B组有效率分别为12.9%和25.8%,疾病控制率分别为90.3%和93.5%,2组比较差异无统计学意义(P>0.05)。A组中位PFS为17.4个月优于B组9.6个月(95%可信区间,5.2个月to 19.7个月,P=0.264)。亚组分析鳞癌患者应用白蛋白结合型紫杉醇联合顺铂方案化疗优于脂质体紫杉醇联合顺铂。2组主要不良反应为骨髓抑制和消化道反应。Cox多因素分析提示性别、年龄、LDH反应性均是影响预后的独立危险因素;女患者预后较男患者好(HR=3.231,P=0.014),初治时年龄大于60岁的患者预后较好(HR=0.287,P=0.005),LDH反应组比不反应组预后好(HR=0.379,P=0.027)。结论脂质体紫杉醇联合顺铂和白蛋白结合型紫杉醇联合顺铂均为较好的治疗方案,LDH反应性可能预测晚期NSCLC患者疗效。
Objective To compare the clinical efficacy and prognosis of paclitaxel liposome combined with cisplatin and albumin-bound paclitaxel combined with cisplatin as the first-line treatment in advanced non-small cell lung cancer（NSCLC）,and to investigate the role of serum lactate dehydrogenase（LDH）in the prognosis evaluation of advanced NSCLC.Methods Sixty-two patients with pathology confirmed advanced NSCLC were randomly divided into combined al-bumin-bound paclitaxel and cisplatin treatment group（group A）and combined paclitaxel liposome and cisplatin treatment group（group B）,with 31 patients in each group.Clinical efficacy,adverse reactions and long-term survival were analyzed in both groups.In addition,according to the chan-ges in serum LDH levels after chemotherapy,patients were divided into response group（LDH lev-els decreased）and non-response group（LDH levels increased or remained unchanged）.Results＆amp;nbsp;The effective rate and disease control rate were,respectively,12.9% and 90.3% in group A,and 25.8% and 93.5% in group B.The differences were not significant between the two groups.The progression-free survival in group A（17.4 months）was significantly longer than that in group B （9.6 months）（95% confidence interval 5.2-19.7 months;P = 0.264）.The clinical efficacy in group A was better than that in group B.The main adverse reactions included myelosuppression and gastrointestinal reactions.Cox multivariate analysis showed that gender,age and LDH reac-tivity were the independent risk factors influencing prognosis.Female patients,patients older than 60 years of age and patients with LDH reaction had better prognosis than male patients（HR =3.231,P =0.014）,patients younger than 60 years of age（HR =0.287,P =0.005）and patients without LDH reaction（HR = 0.379,P = 0.027）,respectively.Conclusion Paclitaxel liposome combined with cisplatin and albumin-bound paclitaxel combined with cisplatin were effective for advanced NSCLC.LDH reactivity can be used to predict the effic
出处
《南昌大学学报（医学版）》
CAS
2014年第8期32-36,46,共6页
Journal of Nanchang University：Medical Sciences
关键词
非小细胞肺癌
白蛋白结合型紫杉醇
脂质体紫杉醇
化疗
乳酸脱氢酶
non-small cell lung cancer
albumin-bound paclitaxel
paclitaxel liposome
chemotherapy
lactate dehydrogenase
