吉西他滨单药与联合顺铂化疗治疗中老年晚期非小细胞肺癌的疗效观察

目的:评价吉西他滨联合顺铂治疗非小细胞肺癌(NSCLC)与单独使用吉西他滨的疗效与安全性.方法:140例晚期NSCLC(Ⅲb/Ⅳ期)患者随机均分为吉西他滨联合顺铂组(n=70)和单独使用吉西他滨组(n=70).联合给药组患者静脉注射吉西他滨(1 250 mg/m2,第1、8天)和顺铂(75 mg/m2,第1天);单独给药组患者静脉注射吉西他滨(1 250 mg/m2,第1、8天).每21天为一个疗程,共持续4个疗程.结果:吉西他滨与顺铂联合给药组疗效优于吉西他滨单独给药组(P＜0.05).而在血细胞减少、血红蛋白减少以及恶心呕吐等不良反应上,吉西他滨单独给药组低于联合给药组,但组间比较差异无统计学意义(P＞0.05).治疗后2年的随访结果也显示经吉西他滨与顺铂联合治疗的患者1年有效率及中位生存期均优于吉西他滨单独治疗组(P＜0.05).结论:吉西他滨联合顺铂治疗中老年晚期非小细胞肺癌疗效确切,未明显增加不良反应,患者耐受性好,值得临床推广.

Effects of gemcitabine alone and combined with chemotherapy with cisplatin in advanced non-small cell lung cancer for middle and aged patients

Objective:To evaluate the efficacy and safety of gemcitabine combined with cisplatin in the treatment of non-small cell lung cancer (NSCLC) and gemcitabine alone.Methods:140 patients with advanced NSCLC (stage Ⅲb/Ⅳ) were randomly divided into two groups:Gemcitabine plus cisplatin (n =70) and gemcitabine alone (n =70).Patients in the combined treatment group were treated with intravenous gemcitabine (1 250 mg/m2,first,eighth days)and cisplatin (75 mg/m2,first days).The patients in the treatment group were treated with intravenous gemcitabine (1 250 mg/m2,first,eighth days).Each 21 d was a course of treatment,a total of 4 courses of treatment.Results:The effect of gemcitabine and cisplatin group was significantly better than gemcitabine alone group (P ＜0.05).In the side effects of blood cell reduction,hemoglobin reduction and nausea and vomiting,the gemcitabine alone group was lower than the combined treatment group,but there was no significant difference between groups (P ＞ 0.05).The 2-year follow-up results showed that the effective rate and median survival time of patients treated with gemcitabine and cisplatin were significantly better than that of gemcitabine alone (P ＜ 0.05).Conclusion:Gemcitabine combined with cisplatin in the treatment of elderly patients with advanced non-small cell lung cancer is effective,without increasing side effects,the patient is well tolerated and worthy of clinical promotion.