应用紫杉醇脂质体治疗非小细胞肺癌术后淋巴结转移的临床观察

目的评价非小细胞肺癌术后淋巴结转移应用紫杉醇脂质体与传统紫杉醇化疗的临床近期疗效和不良反应的差别。方法将68例非小细胞肺癌术后发现淋巴结转移的患者分成两组:试验组37例,对照组31例。试验组应用紫杉醇脂质体(135mg/m2)进行化疗,对照组应用传统紫杉醇(135mg/m2)进行化疗。两组每周期均联合应用卡铂化疗,剂量为300 mg/m2,每3周为1周期。结果 68例患者均可评价疗效,试验组完全缓解(CR)5例(13.5%),部分缓解(PR)13例(35.2%),总有效率48.7%。对照组CR 1例(3.2%),PR 6例(19.4%),总有效率29.0%,试验组疗效优于对照组(P<0.05)。主要不良反应为骨髓抑制、脱发、肌肉关节酸痛、消化道症状等,无严重过敏反应,试验组过敏反应、恶心、呕吐、肌肉关节痛的发生率低于对照组(P<0.05)。结论对于肺癌术后淋巴结转移患者,紫杉醇脂质体有效率较传统紫杉醇药物高,而且紫杉醇脂质体出现毒副反应者明显减少,药物耐受性高。

Clinical observation of paclitaxel liposome in adjuvant chemotherapy to patients with lymph node metastasis after pulmonary resection

Objective To evaluate the difference of clinical short-term effect and adverse reactions between paclitaxel liposome and paclitaxel in non-small cell lung cancer patients with lymph node metastasis after pulmonary resection. Methods 68 patients after pulmonary resection were randomly divided into two groups,the experimental group included 37 cases used with paclitaxel liposome（135 mg/m2） combined with carboplatin（CBP） at 300 mg/m2 in chemotherapy,and 31 cases in control group with paclitaxel（135 mg/m2） combined with CBP at 300 mg/m2 in chemotherapy. Results All patients were fit for evaluation,in experimental group 5 cases（13.5%） were CR,13 cases（35.2%） were PR,the total effective rate was 48.7%,in control group 1 case（3.2%） was CR,6 cases（19.4%） were PR,the total effective rate was 29.0%.The therapy effects of experimental group were better than those of control group（P0.05）.The main adverse reactions included marrow suppression,hair loss,muscle and joint pain and gastrointestinal symptoms.There were no serious hypersensitity reactions.The rates of allergic reactions,nausea and vomiting,muscle and joint pain in experimental group were significantly lower than those of control group. Conclusion To patients with lymph node metastasis after pulmonary resection,the rate of curative effect in paclitaxel liposome group is higher than that of pacclitaxel group with lower incidence of side effects.