吉西他滨联合顺铂方案二线治疗晚期非小细胞肺癌的临床观察

目的：观察吉西他滨联合顺铂二线治疗晚期非小细胞肺癌的疗效及不良反应。方法：对38例晚期非小细胞肺癌患者采用二线化疗，入组患者均经病理组织学证实，有可测量病灶，方案为吉西他滨1000mg／m^2第1、8天，顺铂80mg／m^2，分3天应用，21天为1个周期。化疗2个周期后评价疗效及不良反应。结果：所有患者均可评价，共进行108周期的化疗。完全缓解（CR）0例，部分缓解（PR）11例，稳定（SD）12例，进展（PD）15例，总有效率28．9％。中位缓解时间4．5月，中位生存时间7．8月。主要不良反应为血液学毒性，其中Ⅲ／Ⅵ度的中性粒细胞下降、血小板下降和血红蛋白下降分别为18．5％（20／108）、11．1％（12／108）和8．3％（9／108），其次为消化道不良反应，Ⅲ／Ⅵ度的食欲下降和恶心呕吐分别为13．9％（15／108）和12．0％（13／108）。结论：吉西他滨联合顺铂对复治晚期非小细胞肺癌有较好疗效，不良反应可以耐受。

The clinical observation of gemcitabine combined with cisplatin as second -line chemo- therapy for non -small cell lung cancer （NSCLC）

Objective：To investigate the efficiency and toxicity of gemcitabine with cisplatin as second - line chemotherapy for patients with advanced NSCLC. Methods： Thirty eight patients with advanced NSCLC after failure to first- line platinum based chemotherapy received gemcitabine 1000mg/m^2, ivgtt, d1.8 and cisplatin 80mg/m^2, ivgtt, d1 - 3, repeated every 3 weeks and the efficacy and toxicity were evaluated after 2 cycles. Results： The efficiency and toxicity were assessed. Objective response rate（ CR ＋ PR = 0 ＋ 11 ） was 28.9% （ 11/38 ）, median remission time was 4.5 months and the median survival time was 7.8 months. Grade 3/4 of neutropenia, thrombocytopenia and anemia were 18.5 % （20/108）, 11.1% （ 12/108 ） and 8.3 % （9/108）. Grades 3/4 of anorexia and nansea/vomiting were observed in 13.9% （15/108） and 12.0% （13/108） of patients,respectively. Conclusion： As a selective second - line chemotherapy, this regimen is effectaive and tolerable for previous treated patients with NSCLC.