以顺铂为基础的两种联合化疗方案治疗晚期非小细胞肺癌的临床研究

目的　比较顺铂为基础的两种联合化疗方案 :顺铂 (cisplatin ,DDP)联合长春瑞宾 (vinorelbine ,NVB)与顺铂联合紫杉醇 (pacli taxel,Taxel)治疗晚期NSCLC病人的临床疗效及不良反应。方法　住院治疗的中晚期NSCLC患者 48例 ,分别接受顺铂 +长春瑞宾(PN)治疗 2 5例 ,顺铂 +紫杉醇 (PT)治疗 2 3例。按WHO疗效及不良反应评价标准评价 ,完成治疗 2个周期以上的患者进行临床疗效及不良反应评估。结果　可评价患者 45例 ,其中PN组 2 3例 ,有效率 (RR) 2 6 1% (6/2 3 ) ,中位缓解期为 6个月 ,1年生存率3 5 1% (9/2 3 ) ;PT组 2 2例 ,RR 2 7 3 % (6/2 2 ) ,中位缓解期为 7 8个月 ,1年生存率 45 5 % (10 /2 2 )。两组有效率、中位缓解期、1年生存率统计学处理均无差异 (p >0 0 5 )。主要不良反应为骨髓抑制、胃肠道反应、末梢神经炎、肌肉与关节酸痛。结论　PN方案与PT方案具有相近的临床疗效 ,但PN方案较为经济 ,可作为治疗中晚期NSCLC病人的首选方案。

The Clinical Study of Two Different Combined Regimens Based on Cisplatin in the Treatment of Advanced Non-small Cell Lung Cancer

objective To compare the toxicity of two cisplatin-based combination chemotherapy regimens: cisplatin and vinorelbine regimen (PN) vs cisplatin and paclitaxel regimen (PT) in the treatment of advanced non-small cell lung cancer.Methods Forty-eight patients were enrolled in this study, 25 patients received PN regimen and 23 received PT regimen. The patient's clinical efficacy and adverse effect were evaluated after two cycles chemotherapy according to WHO standard. Results There were 45 patients available including 23 in PN group and 22 in PT group. In PN group, the response rate was 26.1%(6/23), the median-remission time 6 months and one-year survival rate 35.1%(9/23); In PT group, the response rate was 27.3%(6/22), the median-remission 7.8 months and one-year survival rate 45.5% (10/22). There were no significant differences of response rate, median-remission and one-year survival rate between PN group and PT group. The major toxic effects of two groups were myelosuppression, gastrointestinal tract reaction, peripheral neuropathy and myalgia or arthralgia. Conclusions The clinical efficacy of two regimens was similar. PN regimen was more economic and may be used as first choice project in the chemotherapy of advanced non-small lung cancer.