顺铂不同剂量联合长春瑞滨治疗非小细胞肺癌的临床研究

目的:对比研究顺铂(DDP)不同剂量联合长春瑞滨(NVB)在非小细胞肺癌(NSCLC)患者化疗中的疗效和不良反应。方法:123例Ⅲ～Ⅳ期NSCLC患者,采用不同剂量DDP联合长春瑞滨进行分组对照研究,分为低剂量DDP组(n=67)与高剂量DDP组(n=56)。低剂量DDP组给予NVB25mg.m-2,静脉滴注,第1、8天;DDP20mg.m-2,静脉滴注,第1～5天。高剂量DDP组给予NVB25mg.m-2,静脉滴注,第1、8天;DDP60mg.m-2,静脉滴注,第1～2天。21d为一周期。化疗2周期后评定疗效。结果:高剂量DDP组与低剂量DDP组的有效率分别为41.1%、28.4%(P>0.05);高剂量DDP组白细胞减少总发生率为87.5%,明显高于低剂量DDP组的71.6%(P<0.05);2组Ⅲ～Ⅳ度白细胞减少发生率无显著性差异(P>0.05)。结论:DDP高剂量组与低剂量组的临床疗效相当。高剂量顺铂组毒性反应的发生率显著高于低剂量组,但严重毒性反应的发生率相近。

Comparative Study of Different Dosage Regimen of Cisplatin Combined Vinorelbine in the Treatment of Non - small Cell Lung Cancer

OBJECTIVE： To evaluate the therapeutic efficacy and toxic reactions of Cisplatin （DDP） in different dosage regimen in combination of vinorelbine （NVB） in the treatment of non small cell lung cancer （NSCLC） . METHODS： 123 NSCLC（ Ⅲ -Ⅳ ） patients were randomly divided into two groups： 67 patients were treated with low dose cisplatin （LD DDP： 20 mg· m^-2, d1-5, iv gtt） plus vinorelbine （25 mg· m^-2, d1, d8. iv gtt）, and another 56 with high dose cisplatin （HD-DDP： 60 mg· m^-2 d1, d2. iv gtt） plus vinorelbine （25 mg· m^-2, d1, d8. iv gtt） for 21 days （1 course of treatment） . Curative effects were evaluated after treatment of 2 courses. RESULTS： CR ＋ PR rate of high dose DDP group was 41.1% versus 28.4% of low dose DDD group （P 〉 0.05） . Incidence rate of leukopenia in the high dose DDP group was significantly higher than in the low dose DDP group （87.5% vs. 71.6% ） （P〈0.05）. However, there was no significant difference between high dose DDP group and low dose DDP group in leukopenia of Ⅲ- Ⅳ- degree （P 〉0.05）. CONCLUSION： The therapeutic effects of high dose DDP and LD-DDP group were equivalent. The incidence rate of toxic effect was significantly higher in the HD- DDP group than in the LD-DDP group, but the rate of serious toxic effect in the two groups was similar.