晚期NSCLC一线化疗疾病控制与生存关系的分析

目的回顾性分析一线化疗疾病控制（DCR）与进展（PD）患者之间生存的差别,探讨DCR可否预测生存。方法本文回顾性分析本院一线含铂联合化疗86例ⅢB期/Ⅳ期非小细胞肺癌（NSCLC）患者,化疗的疗效按WHO标准分为CR,PR,SD,PD。结果一线化疗后DCR共64例（74.4%）[其中CR 0例,PR 30例（34.9%）,SD 34例（39.5%）],PD 22例（25.6%）。DCR和PD患者中位生存期（MST）有统计学意义,为14.2月和5.1月（P〈0.001）。CR＋PR和SD患者MST有统计学意义,为15.0月和11.0月（P=0.030）。COX多因素回归分析显示一线化疗疾病控制（P=0.017）,ECOG评分（P=0.046）是总生存的独立预后因素。结论本研究提示晚期NSCLC患者一线化疗疾病控制患者其生存较进展患者好,疾病控制比化疗有效似乎更能反映化疗疗效,预测生存期。     

艾迪注射液联合NP方案治疗术后复发非小细胞肺癌的临床观察

为了探讨化疗联合艾迪注射液在术后复发非小细胞肺癌(NSCLC)综合治疗中的应用价值,将40例术后复发NSCLC患者随机分为治疗组与对照组(各20例),治疗组采用NP方案(长春瑞滨+顺铂)联合艾迪注射液;对照组采用单纯NP方案。结果全组40例患者中,无CR病例,治疗组PR 4例,SD 11例,PD 5例;对照组PR 3例,SD 8例,PD 9例。治疗组疾病控制率(CR+PR+SD)75%,对照组55%,两组差异有统计学意义,P<0.05。初步研究结果提示,艾迪注射液联合NP方案治疗,能提高疾病控制率,减少不良反应,改善症状,提高术后复发的NSCLC的生存质量。     

吉西他滨单药治疗老年晚期非小细胞肺癌患者36例

目的 观察吉西他滨单药治疗老年晚期非小细胞肺癌(NSCLC)患者的疗效及不良反应.方法 对36例ⅢB～Ⅳ期老年NSCLC患者应用吉西他滨单药化疗(1000mg/m2,第1、8天静脉滴注),21 d为1个周期.2个周期后分别按实体瘤疗效评价标准(RECIST)和美国国立癌症研究所(NCI)常见毒性反应标准评价不良反应,同时评估生活质量改善指标.结果 本组36例患者中,完全缓解(CR)0例,部分缓解(PR)10例,稳定(SD)15例,进展(PD)11例,有效(CR+PR)率为27.8%,临床受益(CR+PR+SD)率为69.4%.中位无进展生存(PFS)期为5.1个月,中位总生存(OS)期为7.8个月,1年生存率为30.6%(11/36).患者不良反应主要表现为以白细胞和血小板减少为主的骨髓抑制,白细胞减少Ⅰ～Ⅱ度发生率为44.4%(16/36),Ⅲ～Ⅳ度11.1%(4/36);血小板减少Ⅰ～Ⅱ度发生率为38.9%(14/36),Ⅲ度2.8%(1/36),无Ⅳ度减少发生.结论 采用吉西他滨单药治疗老年晚期NSCLC患者疗效好、不良反应轻、安全,可作为老年晚期NSCLC患者的一线治疗方案.     

吉西他滨单药治疗老年晚期非小细胞肺癌患者36例

目的 观察吉西他滨单药治疗老年晚期非小细胞肺癌(NSCLC)患者的疗效及不良反应.方法 对36例ⅢB～Ⅳ期老年NSCLC患者应用吉西他滨单药化疗(1000mg/m2,第1、8天静脉滴注),21 d为1个周期.2个周期后分别按实体瘤疗效评价标准(RECIST)和美国国立癌症研究所(NCI)常见毒性反应标准评价不良反应,同时评估生活质量改善指标.结果 本组36例患者中,完全缓解(CR)0例,部分缓解(PR)10例,稳定(SD)15例,进展(PD)11例,有效(CR+PR)率为27.8%,临床受益(CR+PR+SD)率为69.4%.中位无进展生存(PFS)期为5.1个月,中位总生存(OS)期为7.8个月,1年生存率为30.6%(11/36).患者不良反应主要表现为以白细胞和血小板减少为主的骨髓抑制,白细胞减少Ⅰ～Ⅱ度发生率为44.4%(16/36),Ⅲ～Ⅳ度11.1%(4/36);血小板减少Ⅰ～Ⅱ度发生率为38.9%(14/36),Ⅲ度2.8%(1/36),无Ⅳ度减少发生.结论 采用吉西他滨单药治疗老年晚期NSCLC患者疗效好、不良反应轻、安全,可作为老年晚期NSCLC患者的一线治疗方案.     

吉非替尼治疗晚期复治性非小细胞肺癌的临床研究

目的探讨应用吉非替尼(IRESSA)治疗晚期非小细胞肺癌(NSCLC)患者的疗效及其对生活质量的影响。方法既往化疗失败的Ⅲb-Ⅳ期NSCLC患者41例,其中二线化疗失败者占85.4%(35/41)。IRESSA 250 mg口服,每日1次,服药至病情进展或出现不能耐受的不良反应。患者分别在治疗后1个月、2个月和以后每3个月复查。结果本组41例患者均可评价疗效,其中PR 18例,SD 14例,PD 9例,有效率为43.9%(18/41),疾病控制率(PR SD)为78.0%(32/41)。男性患者和女性患者的有效率分别为42.1%和45.5%(P>0.05)。至随访结束,41例患者中,有22例(53.7%)存活,其中位生存时间(MST)为10.1个月;19例死亡患者的疾病进展时间(TTP)为2.7个月,MST为5.0个月;PR患者的MST为13.3个月。全组患者症状改善率为78.0%。服药28 d,KPS评分提高20±5分,无Ⅲ-Ⅳ度毒性反应。结论IRESSA单药对化疗失败的晚期NSCLC疗效确切,并可用于一般状况评分较差的患者,其不良反应轻,是二三线用药的良好选择。     

125I粒子联合化疗治疗非小细胞肺癌

目的探讨125I粒子联合化疗治疗非小细胞肺癌(NSCLC)的临床效果及并发症.方法治疗组(42例)采用CT引导下、PD(处方剂量)=8～10Gy/h植入125I粒子,3 d后紫杉醇+DDP静脉化疗,对照组(46例)单纯紫杉醇+DDP静脉化疗,药物剂量与治疗组参考标准相同.2个月后观察治疗效果(CR,PR,SD,PD).根据生活质量量表EORTC QLQ-C30评价生活质量.结果技术成功率100%,术后随访率100%.治疗组CR 4例(9.5%),PR 14例(33.3%),SD 20例(47.6%),PD4例(9.5%),CR+PR为42.9%;对照组CR 1例(2.2%),PR 8例(17.4%),SD 22例(47.8%),PD 15例(32.6%),CR+PR为19.6%,治疗组总有效率明显高于对照组(P＜0.05).结论对于非小细胞肺癌,125I粒子联合化疗具有优势互补作用,有利于短期内降低肿瘤负荷,提高近期疗效.     

吉非替尼治疗老年非小细胞肺癌的临床分析

为了观察吉非替尼治疗老年非小细胞肺癌(non-small cell lung cancer,NSCLC)的有效性和毒副反应,回顾性研究32例经病理学或细胞学确诊的老年NSCLC,应用吉非替尼(250 mg,口服1次/d)治疗.直到病情进展或出现严重不良反应.32例患者,PR 8例(25.0%),SD 17例(53.1%),PD 7倒(21.9%),有效率(CR+PR)为25%,疾病控制率(CR+PR+SD)为78.1%.女性有效率优于男性,P=0.013.病理、分期及吸烟史等各亚组之间疗效对比均差异无统计学意义,P>0.05.中位生存时间(MST)10.1个月,中位疾病进展时间(MTTP)5.7个月.腺癌和肺泡癌患者的中位生存时间及中住疾病进展时间优于鳞癌及大细胞癌患者,P值分别为0.037和0.024.吉非替尼最主要的毒副反应是皮疹(62.5%)、腹泻(30%)、皮肤干燥(46.9%)及食欲减退(25%).3例因严重皮疹和腹泻而中断治疗.初步研究结果提示,吉非替尼单药治疗老年NSCLC疗效肯定,毒副反应相对较小,患者耐受性好.     

培美曲塞治疗术后复发性非小细胞肺癌的临床分析

背景与目的:Ⅰ～Ⅲa期非小细胞肺癌(non-small cell lung cancer,NSCLC)根治术后5年生存率不足40%,术后复发的治疗迫待解决.本研究旨在观察NSCLC术后复发患者接受培美曲塞治疗的近期疗效与不良反应.方法:分析2006年1月-2008年9月间40例接受培美曲塞(商品名:力比泰)单药或联合卡铂治疗的NSCLC术后复发患者的疗效与不良反应.结果:40例患者中无CR,PR 10例(25.00%),SD 19例(47.50%),PD 11例(27.50%).疾病缓解率(CR+PR)为25.00%;疾病控制率(CR+PR+SD)为72.50%.Fisher精确检验提示,疾病缓解率方面,不同性别、NSCLC病理类型、培美曲塞单药或联合卡铂化疗之间不存在显著性差异.但在疾病控制率方面,女性优于男性(91.30%:47.06%,P=0.034),腺癌患者优于非腺癌患者(87.10%:22.22%,P=0.001),力比泰单药与联合化疗相比无显著性差异.所有患者中位生存期10.70个月,无进展生存期5.18个月,腺癌患者无进展生存期优于非腺癌患者.结论:培美曲塞治疗术后复发性NSCLC安全有效.     

紫杉醇联合顺铂每周方案治疗老年晚期非小细胞肺癌临床观察

背景与目的 肺癌是最常见的恶性肿瘤之一,随着人口老龄化,老年晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的比例逐渐增大,如何给予这些病人最佳的治疗是目前研究的热点.本研究的目的在于观察紫杉醇联合顺铂每周方案一线治疗年龄≥70岁晚期NSCLC患者的疗效和毒副反应.方法 年龄≥70岁初治的晚期NSCLC患者(IIIB和IV期)50例,接受紫杉醇联合顺铂每周方案化疗:紫杉醇(PTX)80 mg/m2加入5%葡萄糖溶液250 mL中静脉滴注1 h,第1,8天,用紫杉醇前常规给予抗过敏预处理;顺铂(DDP)20 mg/m2加入3%氯化钠溶液250 mL中静脉滴注,第1,8天,21天为1周期.结果 共入组50例患者,在可评价疗效的48例患者中,CR 1例,PR 18例,SD 26例,PD 3例,有效率为39.6%,中位生存期为14.8(95%CI:3.2-32.2)个月,1年生存率58.3%,中位疾病进展时间4.5(1.7-7.8)月.主要不良反应是白细胞下降(60%)、贫血(62%)、恶心呕吐(30%)、脱发(100%),未出现与化疗相关的死亡.结论 年龄≥70岁老年晚期非小细胞肺癌(NSCLC)患者可以耐受紫杉醇联合顺铂每周方案化疗,并可以从中获益.     

GP方案联合射频透热治疗中晚期非小细胞肺癌临床观察

目的 评价射频透热联合GP方案治疗中晚期非小细胞肺癌(NSCLC)疗效、毒副反应及对生活质量的影响.方法 经病理学确诊的中晚期NSCLC患者160例,分A、B两组,每组80例.A组予GP方案(健择 顺铂)化疗的同时行病灶部位射频透热治疗;B组单用GP方案化疗.结果 160例均可评价疗效,A组CR 1例(1.2%),PR 36例(45.0%),SD 39例(48.8%),PD 4例(5.0%),有效率(CR PR)46.2%,中位生存期12.9个月,疾病进展时间6.5个月,临床获益率81.2%;B组无CR,PR 35例(43.8%),SD 40例(50.0%),PD 5例(6.2% ),有效率43.8%,中位生存期8个月,疾病进展时间3.85个月,临床获益率50.0%.两组有效率差异无显著性(P＞0.05),中位生存期和疾病进展时间差异有显著性(P＜0.05),临床获益率差异有显著性(P＜0.05).主要不良反应为骨髓抑制、恶心、呕吐 ,两组差异无显著性(P＞0.05).结论 射频透热联合GP方案治疗中晚期NSCLC近期疗效确切,不良反应轻,患者可以耐受,且能明显改善患者的中位生存期和疾病进展时间,提高患者生活质量,值得临床深入研究和探讨.     

转移性结直肠癌一线化疗稳定与有效的患者无生存差异分析

  目的  旨在探讨转移性结直肠癌患者一线化疗后不同疗效分组的生存差异, 以期更好地指导化疗方案的选择。  方法  研究纳入了接受一线化疗的232例复发转移性结直肠癌患者, 按化疗最佳疗效先后分为疾病未进展与疾病进展组, 化疗有效与疾病稳定组, 分别比较两组患者的生存差异, 并分析影响总生存的独立预后因素。  结果  全组患者中位总生存时间(mOS)为21.10个月, 中位无进展生存时间(mPFS)为9.17个月。一线化疗疾病未进展组与进展组的mOS分别为23.57个月和10.67个月, mPFS分别为10.83个月和2.83个月, 差异均有统计学意义(P < 0.001)。疾病稳定组与化疗有效组的mOS分别为23.57个月和24.30个月, mPFS分别为10.57个月和10.87个月, 差异均无统计学意义(P=0.935, P=0.985)。原发病灶是否根治性切除、病理分级、复发转移病灶局部处理、化疗后疾病进展情况是影响总生存的独立预后因素。  结论  复发转移性结直肠癌患者接受一线化疗后, 疾病进展时有必要更换化疗方案, 而近期疗效获得稳定的患者则无需更换化疗方案。      

Efficacy of First-line Chemotherapy Affects the Second-Line Setting Response in Patients with Advanced Non-Small Cell Lung Cancer

Background: Chemotherapy is the mainstay of treatment for the majority of patients with advanced nonsmall cell lung cancer (NSCLC) without driver mutations and many receive therapies beyond first-line. Secondline chemotherapy has been disappointing both in terms of response rate and survival and we know relatively little about the prognostic factors. Materials and Methods: One thousand and eight patients with advanced NSCLC who received second-line chemotherapy after progression were reviewed in Shanghai PulmonaryHospital, China, from September 2005 to July 2010. We analyzed the effects of potential prognostic factors on the outcomes of second-line chemotherapy (overall response rate, ORR; progression free survival, PFS; overall survival, OS). Results: The response and progression free survival of first-line chemotherapy affects the ORR, PFS and OS of second-line chemotherapy (ORR: CR/PR 15.4%, SD 10.1%, PD2.3%, p<0.001; PFS: CR/PR 3.80 months, SD 2.77 months, PD 2.03 months, p<0.001; OS: CR/PR 11.60 months, SD 10.33 months, PD 6.57 months, p=0.578, p<0.001, p<0.001, respectively). On multivariate analysis, better response to first-line therapy (CR/PR: HR=0.751, p=0.002; SD: HR=0.781, p=0.021) and progression within 3-6 months (HR=0.626, p<0.001), together with adenocarcinoma (HR=0.815, p=0.017), without liver metastasis (HR=0.541, p=0.001), never-smoker(HR=0.772, p=0.001), and ECOG PS 0-1 (HR=0.745, p=0.021) were predictors for good OS following secondline chemotherapy. Conclusions: Patients who responded to first-line chemotherapy had a better outcome after second-line therapy for advanced NSCLC, and the efficacy of first-line chemotherapy, period of progression, histology, liver metastasis, smoking status and ECOG PS were independent prognostic factors for OS.     

Survival advantage for carboplatin substituting cisplatin in combination with vindesine and mitomycin C for stage IIIB and IV squamous-cell bronchogenic carcinoma: a randomized phase III study

This communication represents the definitive report of a randomized phase III study comparing cisplatin and carboplatin, in combination with vindesine and mitomycin C in stage IIIB and IV squamous-cell bronchogenic carcinoma. A total of 221 patients entered the study and were randomized into two arms. Of these, 114 patients (109 evaluable for activity) were randomized to arm A, receiving cisplatin 120 mg/m(2), mitomycin C 8 mg/m(2) and vindesine 3 mg/m(2) per cycle; 107 patients (101 evaluable for activity) were randomized to arm B receiving carboplatin 500 mg/m(2) with the same doses of mitomycin C and vindesine per cycle. Patients with progressive disease (PD) were excluded from the study after the 2nd cycle, and those with stable disease (SD), partial response (PR) and complete response (CR) received six cycles of chemotherapy (or less in case of early progression). Patients were stratified according to the clinical stage (IIIB vs. IV), performance status (0+1 vs. 2+3) and tumor histological grade (I+II vs. III). In the cisplatin arm two patients (1.9%) achieved a CR, 38 (34.9%) a PR, 45 (41.2%) a SD and 24 (22.0%) had PD; the overall response rate was 40/109 (36.8%). In the carboplatin arm five patients (5.0%) achieved a CR, 31 (30.7%) a PR, 40 (39.6%) a SD, and 25 (24.7%) had PD; the overall response rate was 36/101 (35.7%). No statistically significant difference in response rate was present between the two arms, and the response rate was not influenced by performance status, histological grade or clinical stage. The Kaplan-Meyers curves displayed a significant advantage both for time to progression (P=0.005) and overall survival (P=0.008) for patients in the carboplatin arm. The advantage for patients receiving carboplatin instead of cisplatin appeared evident in univariate setting for patients with a good performance status and clinical stage IV, and occurred irrespectively of tumor histological grade; response duration and survival of responders was identical in the two arms. Patients achieving a stable disease survived longer in the carboplatin than in the cisplatin arm (P=0.012). Thus, substitution of cisplatin by carboplatin in the combination chemotherapy regimen, although more hematologically toxic (but less emetogenic) resulted in a similar response rate, but a significantly longer time to progression and overall survival.     

易瑞沙治疗化疗失败的晚期非小细胞肺癌

目的观察易瑞沙治疗化疗失败晚期非小细胞肺癌的疗效和不良反应。方法易瑞沙每天口服250mg治疗化疗失败的30例晚期非小细胞肺癌,1个月以后进行疗效评价,无进展者继续服用,之后每个月行CT检查评价疗效并临床密切观察,病情进展或不能耐受相关毒性者则停止使用易瑞沙。结果30例均可评价疗效,无CR者,PR6例(20.0%),SD14例(46.7%),PD10例(33.3%)。有效率(CR PR)为20.0%,疾病控制率(CR PR SD)66.7%,全组中位无进展生存期为3.0个月(0.7～29.0个月),中位生存期6.4个月(1.7～39.0个月)。主要不良反应包括皮疹22例,腹泻2例。没有患者因毒性不能耐受而停药。结论易瑞沙对化疗失败的晚期非小细胞肺癌具有一定疗效,不良反应轻微。     

多西他赛单药治疗老年晚期非小细胞肺癌的临床观察

目的：观察多西他赛单药治疗晚期非小细胞肺癌（ＮＳＣＬＣ）老年患者的临床疗效和不良反应。方法：４２例晚期ＮＳＣＬＣ初治老年患者予以多西他赛７０ｍｇ／ｍ^２治疗,２１天为１周期,治疗２～４周期,随访至疾病进展和死亡。结果：ＣＲ１例,ＰＲ９例,ＳＤ１３例,ＰＤ１７例,总有效率（ＣＲ＋ＰＲ）３５.０％,疾病控制率（ＣＲ＋ＰＲ＋ＳＤ）５７.５％,中位无进展生存期４.２个月,中位生存期６.１个月,１年生存率为３５.８％。主要毒副反应为骨髓抑制和血小板减少。结论：多西他赛单药治疗老年晚期ＮＳＣＬＣ有效且耐受性好。     

厄洛替尼治疗晚期非小细胞肺癌的临床观察

目的观察厄洛替尼治疗晚期非小细胞肺癌的疗效及不良反应。方法32例经放、化疗治疗失败的非小细胞肺癌患者,其中6例肿瘤局限于胸腔内,26例已有远处转移,厄洛替尼剂量为每天150mg,口服,每天1次,直到肿瘤进展或因不良反应不能耐受而中止治疗。结果32例患者中,完全缓解1例,部分缓解9例,稳定13例,进展9例,全组有效率为31.3%,疾病控制率为71.9%,中位生存期7.8月,1年生存率为45.3%。主要不良反应是皮疹和腹泻,不需要特殊处理。结论厄洛替尼对放、化疗失败的晚期非小细胞肺癌有较好的治疗效果,且不良反应轻。     

Survival benefit with erlotinib maintenance therapy in patients with advanced non-small-cell lung cancer (NSCLC) according to response to first-line chemotherapy

BackgroundIn the placebo-controlled phase III SATURN study, maintenance erlotinib after first-line chemotherapy demonstrated significantly prolonged progression-free survival (PFS) and overall survival (OS) in the overall study population of patients with advanced non-small-cell lung cancer (NSCLC).MethodsAfter four cycles of platinum-based doublet chemotherapy, patients without progressive disease (PD) were randomised to erlotinib (150 mg/day) or placebo until PD or unacceptable toxicity. In this pre-planned analysis, data are assessed according to response to first-line chemotherapy (complete/partial response [CR/PR] or stable disease [SD]).ResultsFollowing first-line chemotherapy, 889 non-PD patients were included in the intention-to-treat population (55% SD; 44% CR/PR; <1% unknown response). Erlotinib maintenance therapy significantly prolonged PFS in both the SD (hazard ratio [HR] = 0.68; P < 0.0001) and CR/PR (HR = 0.74; P = 0.0059) groups, while OS was significantly prolonged in the SD group only (HR = 0.72; P = 0.0019). The erlotinib-related OS benefit in the SD group remained significant across subgroups, irrespective of tumour histology and/or EGFR mutation status. The incidence of adverse events was similar in the SD group and the overall population, and erlotinib treatment did not negatively impact quality of life.ConclusionsPatients with advanced NSCLC and SD following first-line platinum-based doublet chemotherapy derive a significant OS benefit from maintenance erlotinib therapy.     

A Phase Ⅱ Trial of Gefitinib as Maintenance Therapy after First-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in China

Objective:To investigate the efficacy and safety of gefitinib as maintenance therapy for advanced non-small cell lung cancer (NSCLC) patients who obtained disease control (DC) after first-line chemotherapy in Chinese population. Methods:Chinese patients with advanced NSCLC treated with standard chemotherapy and obtained DC were assigned to receive gefitinib as maintenance treatment. The primary end point was overall survival time (OS), the second end point was disease control rate (DCR) and progression-free survival time (PFS). DCR included complete response (CR) plus partial response (PR) and plus stable disease (SD). The impact of epidermal growth factor receptor (EGFR) mutation status on the treatment as exploratory point was also evaluated by denaturing high-performance liquid chromatography (DHPLC). Results:Among 75 enrolled patients, the overall response rate was 37% and the DCR (CR + PR +SD) was 66%. The median PFS and OS were 17.13 months and 26.13 months respectively, with 1- and 2-year survival rates 89.3% and 34.7%. Patients harboring somatic EGFR mutations obtained a prolonged median PFS and OS compared with EGFR wide type (25.1 vs. 13.0 months, P=0.019 and 33.37 vs. 25.57 months, P=0.014, respectively). In COX regression model, only EGFR mutation status was the independently factor influencing both PFS and OS (P=0.029 and 0.017, respectively), however, rash status was the predictor in terms of PFS (P=0.027).Conclusion:Gefitinib produced encouraging survival when delivered as maintenance therapy in Chinese patients obtaining DC after first-line chemotherapy, especially for patients carrying somatic EGFR mutations. EGFR mutation is an independently predictive factor of survival.     

托瑞米芬联合长春瑞滨和顺铂二线治疗中晚期非小细胞肺癌的疗效

目的:前瞻性研究托瑞米芬(toremifene, TOR)联合NP方案(顺铂加长春瑞滨)二线治疗含铂联合化疗方案一线治疗失败的中晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者的疗效和安全性.方法:2004年1月-2006年2月,44例接受含铂联合化疗方案一线治疗失败的ⅡB～Ⅳ期NSCLC患者接受了TOR联合NP方案的二线治疗.化疗2个周期后评价疗效和不良反应,并分析生存情况.结果:44例患者的中位化疗周期数为1.8个(范围:1～3个),其中可评价疗效者为37例(既往曾经接受NP方案化疗者21名,接受其他含铂联合化疗方案者16例).37例患者接受二线治疗后,4例获得部分缓解,19例为疾病稳定,14例为疾病进展,无完全缓解者,总有效(完全缓解+部分缓解)率为10.8%(4/37),疾病控制(完全缓解+部分缓解+疾病稳定)率为62.2%(23/37).其中,肺鳞癌患者的有效率和疾病控制率分别为27.3%(3/11)和72.7%(8/11),高于肺腺癌患者的0%(0/18)和44.4%(8/18)(P<0.05).44例患者的中位生存期为8.2个月,中位疾病稳定时间为4.0个月(1.0～10.2个月),总的1年生存率为24.4%.其中,肺鳞癌患者的中位生存期和1年生存率分别为9.2个月和33.3%,肺腺癌患者的中位生存期和1年生存率分别为7.1个月和27.7%,两者比较差异均无统计学意义(P>0.05).男性与女性患者的生存差异也无统计学意义.化疗中,1例患者因肝功能损害(高胆红素血症)中止治疗.化疗不良反应主要包括胃肠反应、骨髓抑制和肝功能损害等,无严重不良反应发生.结论:TOR联合NP方案二线治疗NSCLC患者的疗效与目前的一线含铂联合化疗方案相似,尤其对于肺鳞癌患者而言,且不良反应未见明显增加.