含顺铂三种化疗方案治疗非小细胞肺癌的临床研究

目的：探讨含顺铂3种化疗方案治疗晚期非小细胞肺癌（non small cell lung cancer， NSCLC）的疗效和不良反应。方法：130例晚期NSCLC患者随机分为3组：NP组接受长春瑞滨+顺铂，45例；GP组接受吉西他滨+顺铂，43例；TP组接受多西紫杉醇+顺铂，42例。观察其疗效和不良反应。结果：① NP、GP和TP组近期有效率分别为42.2%(19/45)、44.2%(19/43)和47.6%(20/42)，3组差异无统计学意义(P＞0.05)；② GP组白细胞减少发生率低于NP和TP组(P＜0.05)，血小板减少发生率高于NP和TP组(P＜0.05)，静脉炎的发生仅见于NP组(P＜0.001)，恶心呕吐发生率3组差异无统计学意义(P＞0.05)；③ NP、GP、TP 3组中位生存期和一年生存率分别为9.8月、10.1月、10.3月和39.13%、39.97%、40.25%，差异无统计学意义(P＞0.05)。结论：长春瑞滨、吉西他滨或多西紫杉醇与顺铂分别组成两药联合方案对晚期非小细胞肺癌均有确切疗效，不良反应可逆，患者容易耐受，可作为一线治疗方案应用。

Three chemotherapy regimens including cisplatin for advanced non-small cell lung cancer

Objective： To explore the effect and side effect of three DDP containing combined chemotherapy regimens in the treatment of advanced non small cell lung cancer (NSCLC). Methods： One hundred and thirty patients with advanced NSCLC were randomly divided into three groups: the NP group (n=45) was given vinorelbine plus DDP, the GP group (n=43) was given gemcitabine plus DDP and the TP group (n=42) was given docetaxel plus DDP. Results： ① The short-term response rate of groups NP, GP and TP was 42.2%(19/45), 44.2%(19/43) and 47.6%(20/42), respectively. There was no significant difference in the three groups(P＞0.05); ② Leukopenia was more significantly decreased in the GP group than in the NP and TP groups, and thrombocytopenia was more significantly increased in the GP group than in the NP and TP groups(P＜0.05). Phlebitis only occurred in the NP group (P＜0.001). Nausea and vomiting had no significant difference among the three groups(P＞0.05); ③ The median survival period and the 1-year survival rate of the NP, GP and TP groups were 9.8 months, 10.1 months and 10.3 months and 39.13%, 39.97% and 40.25%, respectively. There was no significant difference in the three groups(P＞0.05). Conclusion： DDP combined with vinorelbine, gemcitabine or docetaxel has a definite efficacy for patients with non-small cell lung cancer. The side effects are reversible and easily tolerated. All three regimens can be applied to first line chemotherapy.