Combined therapy with topotecan and gemcitabine in patients with inoperable or metastatic non-small cell lung cancer

PURPOSE: We conducted a phase I/II trial of topotecan combined with gemcitabine in patients with metastatic or unresectable non-small cell lung cancer (NSCLC) based on preclinical data showing in vitro synergy against an established lung adenocarcinoma cell line. The aim was to determine the maximally tolerated dose (MTD) of topotecan when the gemcitabine dose is held constant, as well the dose limiting toxicity (DLTs) of this combination in NSCLC patients. PATIENTS AND METHODS: Twenty-four patients with stage IIIB or IV NSCLC were treated weekly times 3 with a week break with gemcitabine (1250 mg/m2 over 30 minutes) and topotecan (30 minutes) at varying doses. The starting dose of topotecan was 1.0 mg/m2 and doses were escalated in 0.25-mg/m2 increments until the MTD was achieved. RESULTS: The MTD of gemcitabine/topotecan was 1250 mg/m2 of gemcitabine and 2.00 mg/m2 of topotecan (level 5). Neutropenia was the DLT. Few nonhematologic toxicities were observed. There were 5 (21%) partial responses among 24 patients. The median survival was 22 weeks. Two patients have had prolonged (> 2 year) survival. CONCLUSION: The combination of gemcitabine and topotecan seems to be active against NSCLC with acceptable hematologic toxicity and minimal nonhematologic toxicity. The recommended dose for further study is 1250 mg/m2 of gemcitabine (days 1, 8, 15) and 2.0 mg/m2 of topotecan (days 1, 8, 15) administered every 28 days.     

Elderly patients with advanced non-small cell lung cancer. A pase II study with weekly cisplatin and gemcitabine

OBJECTIVES: The incidence of non-small cell lung cancer (NSCLC) is increasing among the elderly. We studied the toxicity and efficacy of a weekly schedule of gemcitabine and cisplatin in elderly patients with advanced NSCLC. METHODS: Patients aged 70 years or above with advanced NSCLC were treated in a phase II prospective trial with gemcitabine 1,000 mg/m(2) and cisplatin 35 mg/m(2) on days 1, 8 and 15 every 28 days. RESULTS: Forty-eight patients with a median age of 74 years (range 70-78) participated in the study. We observed 14 cases with partial response, 14 with stable disease and 16 with progressive disease, whilst 4 patients were not evaluable. By intention-to-treat analysis, partial response rate was 31.8% whilst progressive disease was 33.3%. Median survival was 9 months; 1-year survival probability was 34.4% and median time to progression was 4 months. Grade III-IV leukopenia was observed in 5/48 patients (10.4%), 20/48 patients (41.7%) had grade III-IV thrombocytopenia and 7/48 patients (14.6%) had grade III-IV anemia. One patient experienced grade III emesis and 2 patients had grade III-IV fatigue. CONCLUSIONS: At this dose and schedule the combination of gemcitabine and cisplatin appears to be an active and well-tolerated regimen for elderly patients with advanced NSCLC.     

Second-line weekly paclitaxel in patients with inoperable non-small cell lung cancer who fail combination chemotherapy with cisplatin

This phase II study was designed to assess single-agent paclitaxel (Taxol), as second-line chemotherapy. Eligibility criteria: pathological diagnosis of inoperable non-small cell lung cancer (NSCLC) relapsing or refractory to standard front-line platinum (P)-based chemotherapy, performance status < or = 3, normal lab tests, informed consent. Ineligibility criteria: history of second or third cancer (unless surgically cured), mental instability or impairment, pre-existing moderate/severe peripheral neuropathy, previous chemotherapy non-including cisplatin, and previous second-line chemotherapy. Paclitaxel was given by intravenous infusion at a dose of 100 mg/m2 every week, until completion of the treatment plan of 21 weeks, disease progression, persistent toxicity, or patient refusal. Thirty-eight patients (32 males) entered the study; median age was 63 years (range 44-74); cell types were: adenocarcinoma (20), squamous (14), large cell (4). Previous chemotherapies: P and vinorelbine (31 patients) and P, mitomycin C and vinblastine (7 subjects), followed by 21 objective responses. Two patients had one course of paclitaxel; six other patients had early treatment suspensions. The median number of weekly infusions was 12 (range 1-21); median dose-intensity was 75% of projected. Toxicity was generally mild, mainly neurological and never life threatening (only 2 grade 4 toxicity out of 468 pre-chemotherapy evaluations). Six patients obtained a partial response; 7 others showed some tumor regression, 3 had tumor stabilization, and 13 disease progression. From the start of paclitaxel, the estimated median time to progression was 20 weeks, the median survival 58 weeks. Second-line treatment with single-agent paclitaxel is well-tolerated, active, and associated to long survivals.     

A phase II study with gemcitabine and split-dose cisplatin in patients with advanced non-small cell lung cancer

BACKGROUND: The combination of gemcitabine and cisplatin is among the most active regimens for the treatment of NSCLC. However, the optimal dose and schedule for administration of the two drugs has not yet been determined. We investigated the activity and toxicity of a gemcitabine and split-dose cisplatin regimen in an outpatient setting for patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: From June 2004 to May 2005 patients with stage IIIB or IV who had not had prior chemotherapy entered the study. Treatment consisted of gemcitabine 1250 mg/m2 and cisplatin 35 mg/m2, both given intravenously on days 1 and 8 every 21 days. RESULTS: Forty-five patients were entered this study. Patient characteristics were as follows: male/female, 34/11; median age (range), 62 (30-76) years; ECOG PS 0/1/2, 7/30/8; stage IIIB/IV, 18/27. A total of 168 cycles were delivered, with a median of 4 cycles (range, 1-6). All patients were evaluable for toxicity. Grade 3 and 4 toxicities according to the NCI toxicity criteria included neutropenia in 8 patients (18%), anemia in 4 (9%), thrombocytopenia in 7 (15%), and emesis in 1 (2%). Of 42 patients assessable for response, 23 patients showed a partial remission. On intent-to-treat basis, the overall response rate was 51% (95% CI, 37-65%). Median time to progression was 6.0 months (range, 1.2-12.0 months) and median overall survival was 13.1 months (range, 1.4-17 months). CONCLUSIONS: This regimen with gemcitabine and split-dose cisplatin using a 21-day schedule appears to be active and very well-tolerated in an outpatients setting for patients with advanced NSCLC.     

Phase II study with gemcitabine, ifosfamide and cisplatin in advanced non-small cell lung cancer

The aim of the present study was to determine the clinical activity and toxicity of a novel chemotherapy combination regimen of gemcitabine, ifosfamide and cisplatin (GIP), administered every 3 weeks, in patients with inoperable non-small cell lung cancer (NSCLC). From October 1998 to July 1999, 18 previously untreated stages IIIb (4) and IV (14) patients were enrolled into the study. Gemcitabine and ifosfamide (with mesna as uroprotection) was administered on days 1 and 6, at a dose of 1000 and 1500 mg/m², respectively; and cisplatin was given on day 1 at a dose of 60 mg/m², every 3 weeks. All 18 patients were evaluable for response and toxicity profiles. One patient achieved a complete response, and 11 patients achieved a partial response, with an overall response rate of 66.7% (95% CI, 45–89%). The main toxicity was hematological, a NCI grade 3–4 neutropenia in 16 patients (88.9%) during the treatment course. Febrile neutropenia occurred in three patients (16.6%). Grade 3 anemia occurred in eight patients (44.4%) and grade 3–4 thrombocytopenia occurred in 11 patients (61.1%). Non-hematological toxicity was mild and tolerable. No toxic death occurred. The median survival was 12.7 months and 1 year survival was 58.4%. The GIP combination chemotherapy produced a high response rate in advanced NSCLC; however, there was a relatively high percentage of hematological toxicity that still could be tolerated. A randomized trial comparing GIP to a two-drug combination of gemcitabine and cisplatin is planned.     

Dose-finding, pharmacokinetic and phase II study of docetaxel in combination with gemcitabine in patients with inoperable non-small cell lung cancer

BACKGROUND: The good efficacy-toxicity ratio of both docetaxel and gemcitabine in non-small cell lung cancer (NSCLC) stimulates the investigation of the combination of these drugs as a first line chemotherapy. This two-step study firstly aimed at determining the maximum tolerated and recommended doses of docetaxel given every 3 weeks in combination with a fixed dose of gemcitabine; the phase I study paid particular attention to pharmacokinetics. Afterwards, the safety and efficacy of the recommended dose was carefully assessed in the phase II-step. METHODS: The following range of docetaxel dosages were tested in the phase I study; 60, 75, 85, and 100 mg m(-2) given on day 8 in combination with gemcitabine 1000 mg m(-2) delivered on days 1 and 8 of a 3-week cycle. Haematopoietic growth factors were not allowed. The treatment was delivered on an outpatient basis. Main eligibility criteria consisted of stage III b or IV histologically proven NSCLC, Eastern Co-operative Oncology Group (ECOG) performance status PS < or =2, age < or =70 years, measurable disease, adequate blood counts, chemistry, and no symptomatic brain metastasis. RESULTS: Four centres enrolled 49 patients (eight having been pre-treated); 16 in phase I and 33 in phase II. The maximal tolerated dose was almost reached at the last dose level (i.e. docetaxel, 100 mg m(-2)). Consequently, we considered the 85 mg m(-2) level as the recommended dose. There was a positive relationship of the docetaxel dose to the area under the curve of this drug. Toxicity was assessable in all patients. Among the 200 cycles delivered, 192 were assessable for this feature. Main toxicity was grade 3-4 neutropenia affecting 23 patients (47% of the population; 23% of the cycles). Six febrile episodes were recorded leading to two treatment-related deaths. Another patient died from congestive cardiac failure. In addition, six patients experienced interstitial pneumonitis, (one half considered as severe), two of them having received the recommended dose. All patients recovered from this toxicity after corticosteroids. Fourteen patients out of the whole population (29%; 95% CI [17-43], including ten patients receiving the recommended dose), achieved an objective response. Median follow-up was 14 months (range, 0.3-29.4). Median survival was 11.2 months (95% CI [8.3-13.2]), and the 1-year survival rate was 45%. CONCLUSION: Gemcitabine, 1000 mg m(-2) days 1 and 8 in combination with docetaxel, 85 mg m(-2), day 8, given every 3 weeks could be considered as an active regimen with manageable toxicities in locally advanced or metastatic NSCLC. This study deserves further comparisons with classical platinum-based regimens.     

Fixed-dose rate infusion of gemcitabine and weekly cisplatin in elderly or poor performance status patients with unresectable non-small cell lung cancer

Purpose  We investigated the efficacy and toxicity of a 4-week schedule of a fixed dose rate infusion of gemcitabine and weekly cisplatin in elderly or poor performance status patients with unresectable non-small cell lung cancer (NSCLC). Methods  In this study, 48 patients with previously untreated NSCLC were given combination chemotherapy that consisted of gemcitabine 1,000 mg/m² (10 mg/m²/min fixed dose rate infusion) and cisplatin 25 mg/m², and both drugs were given weekly on days 1, 8 and 15. Results  A partial response and stable disease were observed in 20 patients (41.7%, 95% CI; 27.8–55.6%) and 12 patients (25.0%), respectively. The overall median survival was 10.30 months (range: 7.85–12.74 months). Major toxicities included neutropenia (grade 3 to 4, 29.2%) and infection (grade 3 to 4, 27.1%). Conclusions  Our results indicate that this regimen is a feasible treatment for elderly or poor performance status patients with unresectable NSCLC. Nevertheless, the morbidity due to myelosuppression and infection following this treatment should be carefully considered. G.-W. Lee and M.-H. Kang contributed equally to this work.     

Vinorelbine, ifosfamide and cisplatin as first-line treatment in patients with inoperable non-small cell lung cancer.

To assess, in a multicenter setting, the effectiveness of a combination of vinorelbine, ifosfamide and cisplatin in the treatment of non-small cell lung cancer, 123 patients (males=116) with a mean age of 60 years (range 27-75) with stage IIIb/IV non-small cell lung cancer (NSCLC) and performance status 相似文献   

NP与GP方案治疗晚期非小细胞肺癌68例疗效分析

为了评价NP和GP方案治疗晚期非小细胞肺癌的疗效和不良反应。将1999年12月2日～2004年5月2日收治的68例非小细胞肺癌（non—small cell lung cancer，NSCLC）患者随机分为两组，分别应用NP和GP方案治疗。NP方案：长春瑞滨（NVB）25mg／m^2，d1、d8；顺铂（DDP）50mg，d3～d5。GP方案：健择（Gemcitabine）1000mg／m^2，d1、d8；DDP50mg，d3～d5，两种方案均21d为1个周期，至少治疗2个周期。结果为NP组35例，无CR，PR17例（48．6％），SD13例（37．1％），PD5例（14．3％），总有效率为48．6％（17／35），临床受益率85．7％（30／35）。GP组33例，CR1例（3．0％），PR14例（42．4％），SD13例（39．4％），PD5例（15．2％），总有效率为45．5％（15／33），临床受益率84．8％（28／33）。NP组和GP组中住进展时间分别为3．2和3．3个月，初治优于复治（NP组60％vs 33％，GP组52．6％ vs 35．7％）。荆量限制性毒性主要为骨髓抑制，NP组和GP组白细胞及血小板下降的发生率分别为80％、22．9％和51．5％、51．5％。NP组静脉炎及胃肠道反应较GP组重（31．4％ vs6．1％和57．1％vs45．5％）。初步研究结果提示，NP和GP方案治疗晚期NSCLC均安全有效，疗效相当，不良反应均可耐受。     

Randomized,multicenter, phase II study of gemcitabine plus cisplatin versus gemcitabine plus carboplatin in patients with advanced non-small cell lung cancer

BACKGROUND: We conducted a phase II randomized study to assess the efficacy, with response as the primary endpoint, and the toxicity of gemcitabine/cisplatin (GP) and gemcitabine/carboplatin (GC) in patients with advanced non-small cell lung cancer (NSCLC). METHODS: Patients were randomized to GP (gemcitabine 1200 mg/m(2), days 1 and 8 plus cisplatin 80 mg/m(2) day 2) or GC (gemcitabine 1200 mg/m(2), days 1 and 8 plus carboplatin AUC=5 day 2). Cycles were repeated every 3 weeks. RESULTS: Sixty-two patients were randomized to GP and 58 to GC. A total of 533 cycles were delivered (264 GP, 269 GC), with a median of four cycles/patient. The objective response rate was 41.9% (95% C.I., 29.6-54.2%) for GP and 31.0% (95% C.I., 18.2-42.8%) for GC (P=0.29). No significant differences between arms were observed in median survival (10.4 months GP, 10.8 months GC) and median time to progression (5.4 months GP, 5.1 months GC). Both regimens were very well tolerated with no statistical differences between arms in grade 3/4 toxicities. When all toxicity grades were combined, emesis, neuropathy and renal toxicity occurred more frequently on the GP arm (P<0.005). CONCLUSIONS: GC arm did not provide a significant difference in response rate compared with GP arm, with better overall tolerability. Carboplatin could be a valid alternative to cisplatin in the palliative setting.     

NP与GP方案治疗晚期非小细胞肺癌68例疗效分析

为了评价NP和GP方案治疗晚期非小细胞肺癌的疗效和不良反应。将1999年12月2日～2004年5月2日收治的68例非小细胞肺癌(nonsmallcelllungcancer,NSCLC)患者随机分为两组,分别应用NP和GP方案治疗。NP方案:长春瑞滨(NVB)25mg/m2,d1、d8;顺铂(DDP)50mg,d3～d5。GP方案:健择(Gemcitabine)1000mg/m2,d1、d8;DDP50mg,d3～d5,两种方案均21d为1个周期,至少治疗2个周期。结果为NP组35例,无CR,PR17例(48.6%),SD13例(37.1%),PD5例(14.3%),总有效率为48.6%(17/35),临床受益率85.7%(30/35)。GP组33例,CR1例(3.0%),PR14例(42.4%),SD13例(39.4%),PD5例(15.2%),总有效率为45.5%(15/33),临床受益率84.8%(28/33)。NP组和GP组中位进展时间分别为3.2和3.3个月,初治优于复治(NP组60%vs33%,GP组52.6%vs35.7%)。剂量限制性毒性主要为骨髓抑制,NP组和GP组白细胞及血小板下降的发生率分别为80%、22.9%和51.5%、51.5%。NP组静脉炎及胃肠道反应较GP组重(31.4%vs6.1%和57.1%vs45.5%)。初步研究结果提示,NP和GP方案治疗晚期NSCLC均安全有效,疗效相当,不良反应均可耐受。     

Phase II trial of weekly docetaxel and gemcitabine as first-line therapy for patients with advanced non-small cell lung cancer

Background A platinum doublet has been the standard treatment for patients with advanced non-small cell lung cancer (NSCLC) and good performance status. This treatment results in almost a doubling of 1-yr survival, along with an improvement in quality of life despite treatment-related toxicities. However, platinum-based treatment may be associated with significant toxicity. Materials and Methods In this trial, we prospectively evaluated a weekly regimen of docetaxel and gemcitabine for advanced NSCLC. The endpoints of this study included objective response rate, survival, and toxicity. Forty-two patients with previously untreated, advanced NSCLC with PS 0-1 were included. Patients received docetaxel (36 mg/m²) and gemcitabine (600 mg/m²) on d 1, 8, and 15 of a 28-d cycle. Responses were assessed every two cycles. The median age was 63 yr; with 22 males and 20 females; 67% were ≥60 years old; and 38 patients had stage IV disease. Results In the intent-to-treat (ITT) analysis of response, 16 patients had a partial response (38%) and 15 patients had stable disease (36%). The 1-yr survival was 48%; median survival for all patients was 11.3 mo and the median progression-free survival was 5.1 mo. Toxicities (≥grade 3) included neutropenia (29%), asthenia (26%), diarrhea (14%), thrombocytopenia (10%), pneumonitis (7%), peripheral neuropathy (5%), peripheral edema (5%), nail changes (2%), and myositis (2%). Conclusions This study demonstrated that this non-platinum doublet (docetaxel+gemcitabine) given on a weekly schedule for advanced NSCLC was well tolerated with efficacy comparable to that reported with platinum-based chemotherapy regimens.     

A phase I study of moderate-dose radiation therapy and weekly gemcitabine in patients with locally advanced non-small cell lung cancer not suitable for radical chemoradiation therapy

AimsTo describe the toxicity and response seen in patients receiving moderate-dose radiation therapy with concurrent weekly low-dose gemcitabine in the management of locally advanced non-small cell lung cancer (NSCLC).Materials and methodsEighteen patients with confirmed NSCLC were enrolled over a 17-month period from August 2000 until January 2002. All had localised disease but were considered unsuitable for curative therapy. Radiation therapy was given to a dose of 30 Gy in 15 fractions over 3 weeks. Gemcitabine was given weekly before and within 3 h of fractions 1, 6 and 11. The study was designed as a dose-escalation study, commencing at 100 mg/m² and increasing at levels of 50 mg/m², until the maximum tolerated dose (MTD) was reached.ResultsThe MTD was regarded as being 150 mg/m². The major acute toxicity observed was oesophagitis. Skin reactions were also reported. The overall response rate in all patients was 88%, with 44% achieving a complete response.ConclusionThe combination of gemcitabine and moderate-dose radiation therapy is feasible, and offers low toxicity and excellent response rates in patients with localised NSCLC not suitable for high-dose therapy.     

A phase I study of weekly docetaxel and cisplatin in advanced non-small cell lung cancer.

This phase I study was designed to determine the maximum tolerated dose (MTD) and toxicity of a weekly docetaxel (TXT) and cisplatin (CDDP) combination regimen in advanced non-small cell lung cancer (NSCLC). Patients with stage IIIB or IV NSCLC who were previously untreated were eligible. Docetaxel, at a starting dose of 20 mg m(-2) per week on days 1, 8 and 15, was combined with a fixed dose of cisplatin 80 mg m(-2) on day 1. Docetaxel was increased in 5 mg m(-2) per week steps. Chemotherapy was given in a 4-weeks cycle. Dose-limiting toxicities (DLTs) were defined as grade 3-4 leukopenia, thrombocytopenia, anemia, fever with grade 4 neutropenia and more than grade 2 non-hematologic toxicity, with the exception of nausea, vomiting, and alopecia. Omission of chemotherapy on day 8 and/or 15 was also considered DLT. Eighteen patients were enrolled in this study. Leukopenia, anemia and fatigue were the DLTs. No grade 4 toxicities were seen in any patients. The overall response rate was 44.4% (95% confidence interval, 21.5-67.4%). The recommended dose of TXT to be combined with CDDP 80 mg m(-2) on day 1 is 35 mg m(-2) per week on days 1, 8 and 15. This is a promising regimen, therefore a multicenter phase II study is now under way.     

吉西他滨同期放射治疗对不能手术的Ⅲ期非小细胞肺癌患者的疗效观察

背景与目的:放射治疗是肺癌的一种有效的治疗方式,加入吉西他滨后能否提高放射治疗疗效尚无定论.本研究探讨吉西他滨同期放射治疗对不能手术的Ⅲ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的疗效、毒副反应和生存情况.方法:共入选60例患者,分为试验组和对照组,每组各30例.试验组采用吉西他滨400 mg/m2,30 min内静滴完,每周一次,同期放射治疗,放射治疗为常规分割,DT 60～66 Gy/30～33F/6～6.5W,同时给予支持治疗.对照组除不给予吉西他滨外,其它与试验组相同.用WHO的标准评价疗效;用x2检验比较有效率、毒副反应和长期生存;用Kaplan-Meier方法计算生存率.结果:58例患者随访资料完整,随访率为96.7%.试验组和对照组的有效率分别为70.0%和60.0%(P＞0.05);消化道和血液学的毒副反应比较,差异无统计学意义(P＞0.05).Kaplan-Meier生存分析显示,试验组1、2、3年生存率分别为77.7%、58.6%、26.4%,对照组1、2、3年生存率分别为70.3%、30.1%、16.1%,经比较两者差异无统计学意义(P＞0.05).结论:对不能手术的Ⅲ期NSCLC患者,吉西他滨同期放射治疗的有效率和1、2、3年生存率均较单纯放疗有所提高,但两组比较未达统计学意义,不良反应可以耐受.     

Phase I trial of weekly docetaxel combined with cisplatin in patients with non-small cell lung cancer

The phase I study was conducted to evaluate the maximum tolerated dose (MTD) and toxicity of weekly administered docetaxel combined with cisplatin in patients with non-small-cell lung cancer (NSCLC). In a dose escalation study, 22 patients, under 75 years old, with unresectable and metastatic untreated NSCLC with performance status (0-1) were enrolled. Patients were treated with cisplatin (day 1) and weekly docetaxel (days 1, 8, 15). Dose escalation levels in mg/m(2) were for cisplatin and docetaxel; 70 and 15 (level 1), 80 and 15 (level 2), 80 and 20 (level 3), 80 and 25 (level 4), 80 and 30 (level 5), respectively. Chemotherapy was repeated for at least two cycles every 28 days. All patients were assessable for toxicities. Although grade 3 neutropenia occurred in one case in level 4, there were no significant modifications of chemotherapy schedule until level 4. Grade 3 neutropenia occurred in all cases receiving level 5. One patient developed an infection, and two had incomplete recovery of neutropenia by the 28th day after the first cycle of chemotherapy. Nonhematological toxicities, including nephrotoxicity, nausea/vomiting, alopecia and hypersensitivity reaction, were tolerable. However, one case developed severe hyponatremia. Among 21 patients evaluable for response, eight cases achieved partial response, thus the overall response was 39%. Weekly administration of docetaxel at 25 mg/m(2) (days 1, 8, 15) combined with cisplatin 80 mg/m(2) (day 1) is recommended for phase II studies. The responses observed in the present study suggest an identical high degree of activity against NSCLC with less hematotoxicity compared with a standard schedule of cisplatin and docetaxel.     

Carboplatin plus gemcitabine therapy versus carboplatin plus weekly paclitaxel therapy for advanced non-small cell lung cancer

We compared two chemotherapy regimens for advanced non small-cell lung cancer. The CG regimen consisted of carboplatin (AUC 4 to 5) on day 1 plus gemcitabine (1,000 mg/m(2)) on day 1 and 8, every three weeks, while the CP regimen was carboplatin (AUC 6) on day 1 plus paclitaxel (70 mg/m(2)) on day 1, 8 and 15, every four weeks. There was a total of 62 patients, 23 on the CG regimen and 39 on the CP regimen. In initial treatment, the response rate, time to progression and median survival time in the CG regimen and CP regimens were 40% vs 22%, 124 days vs 67 days, and 422 days vs 328 days, respectively. There was no statistical difference in the outcome. However, the toxicity profile was different in the two regimens. Grade 3/4 neutropenia and thrombocytopenia were frequent in the CG regimen (61% vs 31%, p=0.02, 44% vs 3%, p=0.0002, respectively). Non hematological toxicity including grade 2 alopecia was less in the CG regimen (4% vs 36%, p=0.012). In choosing the chemotherapeutic regimen for non small cell cancer, it is important to consider the toxicity.     

吉西他滨联合顺铂化疗对非小细胞肺癌患者肿瘤标志物的影响

目的探讨吉西他滨联合顺铂化疗对非小细胞肺癌患者肿瘤标志物变化的影响。方法选取2014年3月至2014年9月间山东省日照市人民医院收治的90例非小细胞肺癌患者,采用随机数字表法分为GP组(吉西他滨+顺铂)与DP组(多西紫杉醇+顺铂),每组45例,对比两组患者临床疗效、肿瘤标志物变化、卡氏功能状态(Karnofsky)评分、无进展生存期和总生存时间。结果GP组患者治疗总有效率为75.6%,DP组为77.8%,两组比较,差异无统计学意义(P>0.05)。治疗后与治疗前相比,两组患者的肿瘤标志物糖类抗原50(CA50)、细胞角蛋白19片段(CYFRA21-1)和癌胚抗原(CEA)水平均降低,差异均有统计学意义(均P<0.05),而两组患者相比,以上肿瘤标志物水平差异均无统计学意义(均P>0.05)。两组患者的Karnofsky评分、无进展生存期和总生存时间,差异均无统计学意义(均P>0.05)。结论吉西他滨联合顺铂治疗非小细胞肺癌患者疗效突出,能降低肿瘤标志物水平,延长生存时间,提高患者生活质量。