异环磷酰胺联合奈达铂与单药多西他赛二线治疗晚期肺鳞癌的临床比较

目的　比较国产异环磷酰胺（ＩＦＯ）联合奈达铂（ＮＤＰ）与单药多西他赛（ＴＸＴ）二线治疗晚期肺鳞癌的疗效、毒副反应及预后。方法　回顾性分析我院接受二线化疗的７７例晚期肺鳞癌患者的临床资料，３７例接受ＩＦＯ联合ＮＤＰ治疗(联合组），４０例接受单药ＴＸＴ治疗（单药组）。具体用药如下：ＩＦＯ１.３ｇ／ｍ^２，ｄ_１ ～ｄ_３；ＮＤＰ８０～１００ｍｇ／ｍ^２，ｄ_１；ＴＸＴ７５ｍｇ／ｍ^２，ｄ_１。均２１天为１周期，２周期评价疗效和毒副反应。结果　联合组客观有效率（ＲＲ）为４０.５％，单药组ＲＲ为１７.５％，两组差异具有统计学意义（Ｐ＜０.０５）；联合组疾病控制率（ＤＣＲ）为８６.５％，单药组ＤＣＲ为７５.０％。联合组１年生存率为３２.１％，中位总生存期（ＯＳ）为１０.０个月，单药组１年生存率为２９.２％，中位ＯＳ为９.０个月，两组差异无统计学意义（Ｐ＞０.０５）；联合组中位无进展生存期（ＰＦＳ）为１８.０周，单药组中位ＰＦＳ为１３.０周，两组差异有统计学意义（Ｐ＜０.０５）。联合组的毒副反应包括白细胞减少、血小板减少及恶心、呕吐，发生率均明显高于单药组。经Ｃｏｘ多元回归分析，治疗前ＰＳ评分、肿瘤分期及二线治疗获益情况均为影响患者生存的独立预后因素。结论　ＩＦＯ联合ＮＤＰ方案较单药ＴＸＴ二线治疗晚期肺鳞癌患者未显著增加患者的ＯＳ，但近期有效率更高，并能延长患者的ＰＦＳ；血液学及消化道毒副反应更明显，但可耐受。

Comparison of ifosfamide plus nedaplatin and single agent docetaxel in second-line treatment for advanced lung squamous cell carcinoma

Objective To contrast ifosfamide plus nedaplatin and single agent docetaxel in the therapeutic efficacy,toxic reactions and prognostic factors as second-line treatment for advanced lung squamous cell carcinoma patients. MethodsThe clinical data of 77 patients with advanced lung squamous cell carcinoma received second-line chemotherapy in Hunan cancer hospital were analyzed retrospectively.Among them,37 patients received ifosfamide plus nedaplatin(combination agent) and others received docetaxel only(single ...