去甲长春碱持续输注加顺铂联合治疗中晚期非小细胞肺癌临床观察

 目的 观察去甲长春碱持续静脉输注加顺铂治疗非小细胞肺癌的疗效及毒性作用。方法对去甲长春碱持续静脉输注组（改良NP组）与常规去甲长春碱加顺铂方案组（NP方案组）临床资料进行分析比较。结果 改良NP组有效率为46.42 %，NP方案组有效率为44.44 %，两组差异无统计学意义（P＞0.05），毒性作用两组主要为骨髓抑制，白细胞减少发生率分别为 50.00 %和81.48 %，两者比较差异有统计学意义（P＜0.05）。结论 去甲长春碱持续静脉输注联合顺铂与常规NP方案比较，血液学毒性明显减轻，采用锁骨下深静脉置管避免了静脉炎发生，值得临床推广使用。     

去甲长春碱加顺铂治疗非小细胞肺癌的临床观察

目的：观察去甲长春碱（Ｎａｖｅｌｂｉｎｅ,ＮＶＢ）加顺铂（Ｃｉｓｐｌａｔｉｎ,ＤＤＰ）治疗非小细胞肺癌（ｎｏｎ ｓｍａｌｌ ｃｅｌｌ ｌｕｎｇ ｃａｎｃｅｒ,ＮＳＣＬＣ）的疗效和安全性。方法：治疗ＮＳＣＬＣ２６例,采用ＮＶＢ３０ｍｇ／ｍ＾２静脉推入,第１、８天;ＤＤＰ２０ｍｇ静脉点滴,连用５天。结果：部分缓解（ＰＲ）１０例,稳定（ＳＤ）８例,进展（ＰＤ）４例,总有效率４５．４％。ＮＶＢ的主要毒性反     

奥沙利铂加去甲长春碱治疗晚期非小细胞肺癌的疗效观察

 目的 观察艾恒（L-OHP）加去甲长春碱（NVB）治疗晚期非小细胞肺癌（NSCLC）的疗效和毒性。方法 20例晚期非小细胞肺癌患者，NVB 25 mg／m2+生理盐水50ml静脉滴注，第1，8天，L-OHP 130 mg／m2+5 %葡萄糖500 ml静脉滴注2 h以上，第2天。21 d为1周期，3周期后评价疗效和毒性。结果 20例中CR 0例，PR 7例（35 %），CR+PR 35 %，中位无进展缓解期5个月（3.1 ~ 6.9个月），总中位缓解期9.8个月（2.2 ~ 17.5个月），NC 6例（30 %），PD 7例（35 %），1年生存率40 %。毒副作用主要为白细胞减少，神经毒性较常见。结论 L-OHP加NVB治疗晚期NSCLC，疗效肯定，毒副反应轻，可在临床上一步进一步使用。     

去甲长春碱加顺铂治疗非小细胞肺癌的临床观察

目的 :观察去甲长春碱 (Navelbine ,NVB)加顺铂 (Cisplatin ,DDP)治疗非小细胞肺癌 (nonsmallcelllungcancer ,NSCLC)的疗效和安全性。方法 :治疗NSCLC 2 6例 ,采用NVB 30mg/m2 静脉推入 ,第1、8天 ;DDP 2 0mg静脉点滴 ,连用 5天。结果 :部分缓解 (PR) 10例 ,稳定 (SD) 8例 ,进展 (PD) 4例 ,总有效率 4 5 4 %。NVB的主要毒性反应为骨髓抑制 ,白细胞下降占 61 5% ,其中 3、4度占 34 6%。其他毒性反应有恶心呕吐 ( 53 9% ) ,局部静脉炎 ( 36 7% )。结论 :NVB加DDP联合治疗NSCLC有一定的疗效 ,对既往化疗无效的患者可作为挽救化疗方案使用。毒性主要为骨髓抑制 ,可用G CSF治疗     

吉西他滨联合顺铂与去甲长春碱联合顺铂治疗晚期非小细胞肺癌的临床研究

目的 观察比较吉西他滨联合顺铂(GC方案)与去甲长春碱联合顺铂(VC方案)治疗晚期非小细胞肺癌的疗效、生存率及毒副反应。方法 对67例经病理或细胞学证实的晚期非小细胞肺癌患者给予联合化疗，GC方案32例，VC方案35例，两组病例具有可比性。吉西他滨1000～1250mg／m^2，静脉滴注第1、8天，顺铂80～100mg／m^2，静脉滴注第1～3天，去甲长春碱25mg／m^2，静脉滴注第1、8天，21天为一个周期，每例患者治疗2周期以上。结果 GC组总有效率37．5％，1年生存率38．7％，中位生存期9．5个月；VC组总有效率34．3％，1年生存率34．3％，中位生存期8．6个月。两组间有效率、1年生存率比较差异均无显著性(P=0．59，P=0．48)。最常见的毒副反应为骨髓抑制，GC组Ⅲ～Ⅳ度血小板减少发生率显著高于VC组(P=0．015)，而VC组Ⅲ～Ⅳ度白细胞减少发生率显著高于GC组(P=0．01)。结论 吉西他滨联合顺铂和去甲长春碱联合顺铂治疗NSCLC，疗效肯定，毒性均可耐受。两方案疗效无显著性差异。     

紫杉醇持续输注联合顺铂治疗晚期非小细胞肺癌

背景与目的：在许多国家肺癌的发病率和死亡率急剧增长，治疗肺癌的药物和方法不断涌现。本研究探讨紫杉醇静脉持续注射联合顺铂治疗晚期非小细胞肺癌的疗效和毒性。方法：61例晚期非小细胞肺癌患者被随机分为两组，治疗组（31例）方案：紫杉醇按总量150mg／m^2 48h静脉持续输注，第1～2天；顺铂按总量75mg／m^2分3d静点，即第3、4、5天。对照组（30例）方案：紫杉醇按总量150mg／m^2分2次静点，即第1、8天，每次持续3h，顺铂用法同治疗组。所有患者每周期21d，每个患者治疗3个周期以上。结果：治疗组与对照组的近期有效率分别为54．84％（17／31）、43．33％（13／30），中位治疗进展时间7．1个月、5．8个月，中位生存时间（MST）14．0个月、10．2个月，1年生存率67．74％（21／31）、33．33％（10／30），2年生存率22．58（7／31）％、13．33％（4／30），其中1年生存率治疗组显著高于对照组（P〈0．05），其余差异均无显著性（P〉0．05）。两组患者的不良反应有：骨髓抑制、恶心呕吐、脱发、外周神经毒性、肝功异常、肾功异常、静脉炎，两组发生率相当。结论：较传统用法，紫杉醇持续输注治疗晚期非小细胞肺癌能够提高有效率，显著改善生存情况。毒副反应无明显增加。     

去甲长春花碱加顺铂治疗晚期非小细胞肺癌近期疗效分析

目的：分析晚期非小细胞肺癌采用去甲长春花碱加顺铂化疗的疗效。方法：３１便晚期非小细胞肺癌患者，采用去甲长春花碱（ＮＶＢ）中顺铂（ＤＤＰ）联合化疗部效分析。结果：总有效率５８．０６％，完全缓解率９．６８，中位缓解期８个月。本组病人均有不同程度的胃肠道反应和白细胞下降。白细胞下降占２８％；静脉炎为２９．０３％；未见肾毒性；结论：去甲长春花碱加顺铂联合化疗治疗晚期非小细胞肺癌是较好的化疗方案     

国产去甲长春碱与卡铂联合治疗老年非小细胞肺癌疗效观察

  目的 观察国产去甲长春碱（NVB）与卡铂（CBP）联合方案（NC方案）治疗老年中晚期非小细胞肺癌（NSCLC）的疗效及安全性。方法 NVB 25 mg／m2加入0.9 %生理盐水150 ml，15 min静脉滴注，第1，8天，并于滴注前、后各静脉冲入地塞米松5 mg；BPC 300 mg／m2加5 %葡萄糖注射液500 ml静脉滴入3 h，第1天或第2天，化疗前常规应用盐酸格雷司琼止吐，化疗后每隔2 d复查血常规1次。结果 该组24例，总有效率为41.7 %，初治病例有效率为45 %，复治病例为25 %。毒副反应主要为骨髓抑制，发生率为100 %。其中Ⅲ～Ⅳ度骨髓抑制发生率为21 %，经用粒细胞集落刺激因子（G-CSF）治疗及对症治疗后恢复。29 %的患者出现血小板减少，均在Ⅰ～Ⅱ度之间，未出现Ⅲ度血小板下降，化疗未受影响。结论 NC方案可以作为老年NSCLC一线可选择的方案，其安全性可靠，毒副反应比较轻。     

去甲长春花碱联合顺铂治疗晚期非小细胞肺癌疗效观察

目的观察去甲长春花碱(NVB)、顺铂(DDP)联合治疗晚期非小细胞肺癌疗效.方法NVB 25mg/m2静滴,第1、8天.DDP40mg/m2静滴,第1、8天,21天为一周期.结果全组21例,完全缓解(CR)2例,部分缓解(PR)8例,总有效率47.6%.结论去甲长春花碱联合顺铂治疗晚期非小细胞肺癌疗效较好.     

去甲长春花碱联合顺铂治疗晚期非小细胞肺癌疗效观察

目的观察去甲长春花碱(NVB)、顺铂(DDP)联合治疗晚期非小细胞肺癌疗效.方法NVB 25mg/m2静滴,第1天、8天.DDP 40mg/m2静滴,第1天、8天、21天为一周期.结果全组54例,完全缓解(CR)4例,部分缓解(PR)21例,总有效率46.3%.结论去甲长春花碱联合顺铂治疗晚期非小细胞肺癌疗效较好,副反应可以耐受.     

长春瑞滨加顺铂治疗48例晚期非小细胞肺癌

目的：观察长春瑞滨加顺铂联合中治疗晚期非小细胞肺癌的临床疗效。方法：48例Ⅲ-Ⅳ期非小细胞肺癌（22例初治、26例复治）,采用长春瑞滨25mg/m^2,静注,第1,5天,顺铂35mg/m^2,静注,第1－3天,联合化疗。结果：初治22例中CR＋PR14例,有效率63．6％,复治26例中CR＋PR10例,有效率38．5％,总有效率50％。中位缓解期5．5个月,中位生存期11个月。主要副反应为骨髓抑制及静脉炎,采用深静脉给药可减轻静脉炎发生。结论：长春瑞滨加顺铂联合化疗治疗晚期非小细胞肺癌疗效较高,副反应可耐受,值得临床进一步观察。     

吉西他滨联合顺铂治疗晚期非小细胞肺癌的临床观察

目的：总结西宁地区（海拔2260m）盐酸吉西他滨联合顺铂化疗方案治疗晚期非小细胞肺癌（NSCLC）的疗效及不良反应。方法：我科30例Ⅲ、Ⅳ期非小细胞肺癌患者，应用GP方案盐酸吉西他滨t250mg／m2（d，8）于60rain内静脉滴注，顺铂30mg／m2（d1-2）静脉滴注，21d为1周期，治疗2个周期后评价疗效。结果：CR0例，PR14例，sD8例，PD8例，总有效率（PR＋CR）为46．7％（14／30）；不良反应为白细胞、血小板下降和恶心、呕吐，但均可耐受。结论：高海拔地区应用盐酸吉西他滨联合顺铂方案，治疗晚期非小细胞肺癌有较好的疗效，且不良反应可以耐受。     

First-line treatment of advanced non-small-cell lung cancer with docetaxel and cisplatin: A multicenter phase II study

Purpose: To evaluate the efficacy and safety of the docetaxel-cisplatin combination in patients with advanced non-small-cell lung cancer (NSCLC).Patients and methods: Chemotherapy-naïve patients with histologically confirmed, measurable stage IIIB or IV NSCLC, a World Health Organization (WHO) performance status of 0–2 and adequate bone marrow, renal, hepatic and cardiac function were eligible for the study. Patients received docetaxel (100 mg/m²) as an one-hour infusion on day 1 and cisplatin (80 mg/m²) as a 30-min infusion with appropriate hydration on day 2. Granulocyte colony-stimulating factor (G-CSF; 150 µg/m² , SC) was given on days 3 to 13. Treatment was repeated every three weeks.Results: Fifty-three patients were enrolled (28 with stage IIIB and 25 with stage IV). One complete and 23 partial responses were observed (overall response rate (OR): 45%; 95% CI: 34.1%–61.8%). The response rate was 57% and 32% in patients with stages IIIB and IV disease (P = NS). The median time to progression was 36 weeks and the median survival 48 weeks; the one-year survival was 48%. Grade 3–4 neutropenia occurred in 23 patients, 15 of whom were hospitalized for neutropenic fever; two patients died of sepsis. Grade 2 neurotoxicity was observed in six patients and grade 3 in five patients; grade 3 fatigue occurred in seven patients, grade 3–4 mucositis in four patients and grade 3–4 diarrhea in six patients. Mild allergic reactions and oedema were observed in five and four patients, respectively. The median dose intensity was 30 mg/m² /week for docetaxel and 24 mg/m² /week for cisplatin, corresponding to 91% and 89% of the specified protocol doses, respectively.Conclusions: The docetaxel–cisplatin combination is an active regimen in advanced NSCLC, but hematologic toxicity remains high despite the prophylactic use of G-CSF.     

吉西他滨联合顺铂治疗30例非小细胞肺癌

目的:评价吉西他滨联合顺铂治疗非小细胞肺癌的疗效及毒副作用。方法:30例晚期非小细胞肺癌,初治14例,复治16例,采用吉西他滨1000mg/m2,第1、8天静脉滴注。顺铂:80mg/m2,分3天静脉滴注,21天为1个周期,至少连用2个周期。结果:部分缓解(PR)14例,无变化(NC)13例,病变进展(PD)3例,有效率为46.67%。主要毒副反应为骨髓抑止、恶心和呕吐等。结论:吉西他滨联合顺铂对治疗非小细胞肺癌有较好的临床疗效,毒副反应轻,易耐受。     

多西他赛与吉西他滨分别顺泊治疗晚期非小细胞肺癌的临床研究

Objective:The aim of this study was to evaluate the clinical efficacy and side effects of docetaxel/cisplatin regiment and gemcitabine/cisplatin regiment in the patients with advanced non-small-cell lung cancer (NSCLC).Methods:Seventy-six patients with advanced NSCLC who were chemotherapy-naive were enrolled in two groups.In docetaxel group (DP group) the patients received docetaxel 75 mg/m 2 and cisplatin 60mg/m 2 on day 1.In gemcitabine group (GP group) the patients received gemcitabine 1000mg/m 2 on day ...     

Preoperative concurrent chemoradiotherapy with cisplatin and docetaxel in patients with locally advanced non-small-cell lung cancer

The objective of this study was to assess the feasibility and effectiveness of an induction chemoradiotherapy regimen followed by surgery in patients with locally advanced non-small-cell lung cancer (LA-NSCLC). A total of 22 patients with LA-NSCLC were treated with induction chemoradiotherapy consisting of cisplatin (40 mg m(-2)) and docetaxel (40 mg m(-2)) given on days 1, 8, 29 and 36 plus concurrent thoracic irradiation at a dose of 40-60 Gy (2 Gy fraction(-1) day(-1)). Surgical resection was performed within 6 weeks after completion of induction therapy. Objective response to the induction therapy was obtained in 16 patients (73%). In all, 20 patients (91%) underwent surgery and complete resection was achieved in 19 patients (86%). Pathological downstaging and pathological complete response were obtained in 14 (64%) and five (23%) patients, respectively. With a median follow-up period of 32 months, the calculated 3-year overall and progression-free survival rates were 66 and 61%, respectively. It is noteworthy that the 3-year overall survival rate in 14 patients achieving pathological downstaging was extremely high (93%). Toxicity was manageable with standard approaches. No treatment-related deaths occurred. This combined modality treatment is feasible and highly effective in patients with LA-NSCLC. The results warrant further large-scale study to confirm the effectiveness of this regimen.     

Oral vinorelbine in combination with cisplatin: a novel active regimen in advanced non-small-cell lung cancer.

BACKGROUND: A phase II trial of alternating i.v. and oral vinorelbine in combination with cisplatin was designed to determine the response rate, safety profile, progression-free survival, overall survival and quality of life (QoL) in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Fifty-six chemotherapy-na?ve patients received cisplatin 100 mg/m(2) and i.v. vinorelbine 25 mg/m(2) on day 1, followed by oral vinorelbine 60 mg/m(2) on days 8, 15 and 22, every 28 days. RESULTS: After an independent review, the response rate was 33% [95% confidence interval (CI) 20% to 46%]. Median progression-free and overall survival were 5.5 months (95% CI 3.7-6.4) and 8.9 months (95% CI 8.8-11.7), respectively. The most frequent hematological toxicities were neutropenia (grade 3-4 in 73% of patients) and anemia (grade 3-4 in 11% of patients). Grade 3-4 infections and non-hematological toxicities occurred occasionally. QoL for lung cancer related symptoms was stable or improved. CONCLUSIONS: The efficacy and safety of the alternating vinorelbine schedule (i.v. on day 1, oral on days 8, 15 and 22) in combination with cisplatin in advanced NSCLC are similar to those of the standard regimen using exclusively i.v. vinorelbine, whereas ease of administration and patient comfort may favor the novel approach.     

Phase I/II study of cisplatin combined with weekly paclitaxel in patients with advanced non-small-cell lung cancer

To determine the maximum-tolerated dose (MTD) and the recommended dose (RD) of paclitaxel administered weekly with a fixed dose of cisplatin, and to assess the toxicity and activity of this combination, we conducted a phase I/II trial in patients with advanced non-small-cell lung cancer (NSCLC). In this study, patients with stage IIIB/IV NSCLC were eligible. Paclitaxel, at a starting dose of 40 mg x m(-2) week(-1) on days 1, 8, and 15, was combined with a fixed dose of cisplatin 80 mg x m(-2) on day 1. Chemotherapy was given in a 4-week cycle. In this phase I/II study, 38 patients were enrolled. Dose-limiting toxicities (DLT) were neutropenia, fatigue, and omission of treatment due to leucopenia, thrombocytopenia, or febrile neutropenia. The MTD and RD were estimated to be 70 mg x m(-2). Of the 37 assessable patients, 23 had a partial response and one had a complete response. Overall response rate was 62.1% (95% confidence interval (CI): 46.5-77.7%). The progression-free survival, the median survival time, and the 1-year survival rate were 5.5 months, 13.7 months, and 56.9%, respectively. This regimen is tolerable and very active against advanced NSCLC, and its efficacy should be confirmed in a phase III study.     

Phase II trial of S-1 and cisplatin with concurrent radiotherapy for locally advanced non-small-cell lung cancer

Background:

To assess the efficacy and safety of S-1 and cisplatin with concurrent thoracic radiation for unresectable stage III non-small-cell lung cancer (NSCLC).

Methods:

Eligible patients were 20–74 years old and had histologically or cytologically confirmed NSCLC, a performance status of 0–1, and no prior chemotherapy. Patients were treated with cisplatin (60 mg m⁻² on day 1) and S-1 (orally at 40 mg m⁻² per dose, b.i.d., on days 1–14), with the treatment repeated every 4 weeks for four cycles. Beginning on day 2, a 60-Gy thoracic radiation dose was delivered in 30 fractions.

Results:

Of 50 patients, 48 were eligible. Partial response was observed in 42 patients (87.5%; 95% CI: 79.1–96.9%). This regimen was well tolerated. Common toxicities included grade 3/4 neutropenia (32%), grade 3/4 leukopenia (32%), grade 3/4 thrombocytopenia (4%), grade 3 febrile neutropenia (6%), grade 3 oesophagitis (10%), and grade 3 pneumonitis (5%). Median progression-free survival was 12.0 months and median overall survival was 33.1 months. The 1- and 2-year survival rates were 89.5 and 56%, respectively.

Conclusion:

This chemotherapy regimen with concomitant radiotherapy is a promising treatment for locally advanced NSCLC because of its high response rates, good survival rates, and mild toxicities.