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1.
目的:观察紫杉醇(paclitaxel,Taxel)、长春瑞滨(vinorelbine,NVB)、吉西他滨(gemcitabine,GEM)分别联合顺铂(cisplatin,DDP)方案对晚期非小细胞肺癌(non-small cell lung cancel,NSCLC)的疗效及毒副反应.方法:93例晚期非小细胞肺癌患者随机分为TP组(紫杉醇 顺铂)32例、NP组(长春瑞滨 顺铂)31例、GP组(吉西他滨 顺铂)30例.给药方法:紫杉醇135mg/m2,第1天;长春瑞滨25mg/m2,吉西他滨1000mg/m2,均在第1、8天使用;顺铂80mg/m2,分2天使用.统计各组有效率(CR PR)、中位生存期(medi-an duration of survival)、1年生存率(1 year survival rate).结果:TP组有效率(CR PR)为43.8%,中位生存期为8.6月,1年生存率为32.1%;NP组有效率为38.7%,中位生存期为8.4月,1年生存率为26.5%;GP组有效率为36.7%,中位生存期为9.4月,1年生存率为38.1%,三组问疗效无显著差异(P>0.05).主要不良反应为骨髓抑制、消化道反应,均可耐受.TP组骨髓抑制发生率相对较高,NP组静脉炎发生率高于TP、GP组,有显著性差异(P<0.05).结论:三种联合化疗方案对晚期NSCLC疗效确切,三种方案间无显著差异,均可作为一线化疗方案在临床应用.  相似文献   

2.
国产吉西他滨联合顺铂治疗晚期非小细胞肺癌的疗效观察   总被引:1,自引:1,他引:1  
背景与目的目前铂类药物为基础的联合化疗被认为是治疗晚期非小细胞肺癌的有效方案。本研究旨在观察国产吉西他滨(gemcitabine,GEM)与顺铂(cisplatin,DDP)联合化疗方案治疗晚期非小细胞肺癌的临床疗效及毒副反应。方法32例患者均为不能手术的Ⅲ、Ⅳ期非小细胞肺癌患者。吉西他滨1000mg/m^2静脉滴注,第1、8、15天;顺铂20mg静脉滴注,第1~5天。每28天为一个周期,治疗3~4周期。结果全组无完全缓解的患者,总有效率为34.4%(11/32)。中位生存期为329天,1年生存率为32.7%。主要毒副反应为骨髓抑制及恶心呕吐,但没有严重的Ⅳ度损害;无明显的肝肾功能损害;无一例因毒性反应而延期化疗。结论吉西他滨加顺铂联合化疗方案治疗晚期非小细胞肺癌有较好的疗效,且耐受性较好。  相似文献   

3.
[目的]比较吉西他滨联合顺铂或奥沙利铂治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。[方法]87例晚期NSCLC患者分为两组:顺铂组42例,吉西他滨1000mg/m2,d1,d8;顺铂25mg/m2,d1~d3。奥沙利铂组45例,吉西他滨1000mg/m2,d1,d8;奥沙利铂130mg/m2,d1。28d/周期。评价有效率、疾病进展时间和毒副反应。[结果]顺铂组与奥沙利铂组的有效率分别为28.6%和31.1%(P=0.8),中位疾病进展时间分别为6.2个月(4.0~8.5个月)和5.7个月(4.5~7.8个月)(P=0.07)。两组主要毒副反应为胃肠道反应、周围神经毒性及骨髓毒性。顺铂组胃肠道反应的发生率(81.0%)明显高于奥沙利铂组(51.1%)(χ2=8.6,P=0.0)。奥沙利铂组的周围神经毒性的发生率(57.8%)明显高于顺铂组4.8%(χ2=28.0,P=0.0)。[结论]吉西他滨联合顺铂或奥沙利铂是晚期NSCLC的有效方案,均可作为晚期NSCLC的一线治疗方案。  相似文献   

4.
目的:观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组(GN组)30例,吉西他滨1000mg/m^2,第1、8天,静脉滴注30分钟,奈达铂80mg/m^2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组(GP组)30例,吉西他滨1 000mg/m^2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m^2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果:GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异(P〉0.05);GP组胃肠道反应(80%)发生率明显高于GN组(56.7%)(P〈0.05);两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显(P〉0.05);血小板下降GN组(73.3%)较GP组(66.7%)显著(P〉0.05),但无统计学差异。结论:吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。  相似文献   

5.
吉西他滨与铂类联合治疗晚期非小细胞肺癌   总被引:3,自引:0,他引:3  
目的观察吉西他滨与铂类联合治疗晚期非小细胞肺癌的临床疗效及不良反应.方法 54例Ⅲb~Ⅳ期非小细胞肺癌患者,38例采用吉西他滨 顺铂(Gem-DDP)方案:吉西他滨1 000 mg/m2,第1、8天,顺铂30 mg/(m2·d),第1~3天化疗;16例采用吉西他滨 卡铂(Gem-CBP)方案:吉西他滨1 000 mg/m2,第1、8天,卡铂以AUC 5的相应剂量为第1天化疗给药量,两方案均3周重复.结果 54例患者总有效率29.6%,中位疾病进展时间3.9个月,中位生存时间7.7个月,1年生存率27.5%;初治组有效率及1年生存率高于复治组,Gem-DDP方案与Gem-CBP方案疗效相似.全组毒副反应主要为骨髓抑制,Gem-CBP方案尤其突出.结论吉西他滨联合铂类治疗晚期非小细胞肺癌对初治患者疗效较好,初步观察Gem-CBP方案疗效与Gem-DDP方案相似,但Gem-CBP方案血液学毒性较重,Gem-DDP方案非血液学毒性较多.  相似文献   

6.
目的评价吉西他滨联合铂类化疗药物治疗晚期非小细胞肺癌(NSCLC)的临床疗效与毒副反应。方法51例晚期NSCLC患者接受吉西他滨与铂类联合化疗:吉西他滨1000mg/m^2,第1天和第8天;顺铂25mg/m^2,第1-3天或卡铂AUC=5第1天;21天为1个周期。结果完全缓解3例,部分缓解20例,有效率45.1%。中位疾病进展时间5.2个月,中位生存期10.1个月,1年生存率39.2%。主要毒副反应为血液学毒性,恶心呕吐等。结论吉西他滨联合铂类化疗药物是治疗晚期NSCLC安全、有效的联合化疗方案,值得临床进一步研究。  相似文献   

7.
目的 :比较吉西他滨加依托泊苷与吉西他滨加顺铂方案对初治晚期非小细胞肺癌的客观疗效及毒副反应。方法 :入组患者分成两组。治疗组 :吉西他滨 1g/m2 3 0分钟静脉滴注 ,第 1、8、15天 ;依托泊苷 50mg/d ,第 1~ 14天口服。对照组 :顺铂 80mg/m2 静脉滴注 ,第 1天 ;吉西他滨用量同治疗组。治疗组和对照组均为每 2 8天重复。所有患者均接受两个疗程以上的化疗。结果 :共收治患者 2 0例 ,其中治疗组疗效为 3 3 3 3 % ,对照组疗效为3 6 3 6%。两组疗效相比差异无显著性 (P >0 0 5)。毒副反应治疗组主要为骨髓抑制、恶心和呕吐等。大部分患者为Ⅰ~Ⅱ度反应 ,患者耐受良好 ,未观察到有严重的毒副反应。结论 :吉西他滨加依托泊苷治疗非小细胞肺癌与吉西他滨加顺铂方案疗效肯定 ,耐受性好  相似文献   

8.
目的 探讨吉西他滨联合顺铂(GP)方案和紫杉醇联合顺铂(TP)方案对初治的晚期非小细胞肺癌(NSCLC)的疗效和不良反应.方法 66例初治晚期NSCLC患者随机分为GP组(34例)和TP组(32例).GP组:吉西他滨1000 ms/m2,第1、8天;顺铂30 ms/m2,第1~3天.TP组:紫杉醇135 mg/m2,第1天;顺铂30 ms/m2,第1~3天.化疗2个周期后对两组的临床疗效和不良反应进行评价.结果 GP和TP两组的有效率分别为41.2%(14/34)和40.6%(13/32).两组资料比较差异无统计学意义.GP组以血小板降低为主,TP组以白细胞降低为主,均在可耐受范围内.结论 GP方案和TP方案对晚期NSCLC疗效肯定,不良反应有一定差异,可根据不同个体选用不同的化疗方案.  相似文献   

9.
目的:评价吉西他滨联合顺铂治疗非小细胞肺癌(NSCLC)与单独使用吉西他滨的疗效与安全性.方法:140例晚期NSCLC(Ⅲb/Ⅳ期)患者随机均分为吉西他滨联合顺铂组(n=70)和单独使用吉西他滨组(n=70).联合给药组患者静脉注射吉西他滨(1 250 mg/m2,第1、8天)和顺铂(75 mg/m2,第1天);单独给药组患者静脉注射吉西他滨(1 250 mg/m2,第1、8天).每21天为一个疗程,共持续4个疗程.结果:吉西他滨与顺铂联合给药组疗效优于吉西他滨单独给药组(P<0.05).而在血细胞减少、血红蛋白减少以及恶心呕吐等不良反应上,吉西他滨单独给药组低于联合给药组,但组间比较差异无统计学意义(P>0.05).治疗后2年的随访结果也显示经吉西他滨与顺铂联合治疗的患者1年有效率及中位生存期均优于吉西他滨单独治疗组(P<0.05).结论:吉西他滨联合顺铂治疗中老年晚期非小细胞肺癌疗效确切,未明显增加不良反应,患者耐受性好,值得临床推广.  相似文献   

10.
奈达铂治疗晚期非小细胞肺癌临床观察   总被引:2,自引:1,他引:1  
目的:观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组(GN组)30例,吉西他滨1000mg/m2,第1、8天,静脉滴注30分钟,奈达铂80mg/m2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组(GP组)30例,吉西他滨1 000mg/m2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果:GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异(P>0.05);GP组胃肠道反应(80%)发生率明显高于GN组(56.7%)(P<0.05);两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显(P>0.05);血小板下降GN组(73.3%)较GP组(66.7%)显著(P>0.05),但无统计学差异。结论:吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。  相似文献   

11.
目的 观察吉西他滨/卡铂(GCarb)和吉西他滨/顺铂(GCis)治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副反应。方法 经病理和细胞学证实的40例晚期NSCLC患者随机分为两组。GCarb组给予吉西他滨1000mg/m^2静脉滴注,第1、8天;卡铂AUC4-6静脉滴注,第1天。GCis组给予吉西他滨1000mg/m^2静脉滴注,第1、8天,顺铂30-40mg/m^2静脉滴注,第1-3天。两组均21天为一周期,连续使用2-3周期评价疗效和毒副反应。结果 GCarb组有效率为65%,GCis组为60%,两组疗效无显著性差异(P>0.5)。两组毒副反应依次为骨髓抑制、胃肠道反应、脱发和皮疹。GCarb组胃肠道反应低于GCis组(P<0.05)。结论 GCarb和GCis均可作为NSCLC的一线治疗方案。  相似文献   

12.
Objective:To compare the efficacy and toxicity between gemdtabine plus cisplatin and plus carboplatin in firstline treatment of advanced non-small call lung cancer (NSCLC).Methods:Gemcitabine 1000 mg/m2 iv,d1,8;cisplatin 75 mg/m2 iv,d1,or 25 mg/m2 iv,d1-3;carboplatin AUC = 5 iv,d1;repeated every 21 days.Results:All 76 cases were available for objective response.Gemcitabine cisplatin (GCis) group:among 33 cases,CR 1 case,PR 13 cases,MR 3 cases,SD 7 cases,PD 9 cases,response rate,disease control rate,time to progress (TTP),median survival time (MST) and 1-,2-year survival rates were 42.42% (14/33),72.73% (24/33),5 months,14 months and 66.67% (22/33),12.12% (4/33),respectively;Gemcitabine carboplatin (GCarb) group:among 43 cases,PR 13 cases,MR 11 cases,SD 7 cases,PD 12 cases,the results while comparing with those of GCis group were 30.23% (13/43),72.09% (31/43),4 months,11 months and 48.84% (21/43),2.33% (1/43),respectively.Among them,only MST between the two groups had significant statistic difference (x2 = 2.45,P = 0.017).Mild to modest myelo-suppression as well as nausea and vomiting were observed.Conclusion:Both GCis and GCarb regimens had active and well-tolerated toxicity for advanced NSCLC.Cisplatin-based chemotherapy yields a substantial effective advantage over carboplatin-based regimens.Therefore,carboplatin and cisplatin are not equal-active and that cisplatin-based doublet regimens should remain the standard first-line therapy for patients with advanced NSCLC with good performance status.  相似文献   

13.
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 ...  相似文献   

14.
Gemcitabine/cisplatin is among the most widely used regimens in Europe for first-line treatment of non-small cell lung cancer (NSCLC). Problems with cisplatin use in this setting include significant nonhematologic toxicity and difficulty of use in outpatients. Carboplatin constitutes a reasonable alternative to cisplatin in this combination, since it shows synergy with gemcitabine in vitro, is easier to use in ambulatory patients, and has a better nonhematologic toxicity profile. Studies of gemcitabine/cisplatin on a 28-day schedule (gemcitabine on days 1, 8, 15 and carboplatin on day 1) generally indicate excessive thrombocytopenia. Use of a 21-day schedule (e.g. gemcitabine on days 1 and 8, carboplatin on day 1) is associated with reduced toxicity and comparable efficacy. Results of one randomized phase II study suggest reduced toxicity and reduced objective response rate with gemcitabine/carboplatin versus gemcitabine/cisplatin. We are currently conducting a phase III comparison of gemcitabine 1200 mg/m(2) on days 1 and 8 plus carboplatin at an area under the curve of 5 mg/ml/min on day 1 versus gemcitabine at the same dose plus cisplatin 80 mg/m(2) on day 1 every 21 days in chemotherapy-nai;ve patients with stage IIIB/IV NSCLC; interim analysis indicates comparable response rates (47 and 48%). A better understanding of the relative toxicities of these regimens should be provided by the final results of this trial.  相似文献   

15.
BACKGROUND: To compare the efficacy and toxicity of three platinum-based combination regimens against cisplatin plus irinotecan (IP) in patients with untreated advanced non-small-cell lung cancer (NSCLC) by a non-inferiority design. PATIENTS AND METHODS: A total of 602 patients were randomly assigned to one of four regimens: cisplatin 80 mg/m(2) on day 1 plus irinotecan 60 mg/m(2) on days 1, 8, 15 every 4 weeks (IP) carboplatin AUC 6.0 min x mg/mL (area under the concentration-time curve) on day 1 plus paclitaxel 200 mg/m(2) on day 1 every 3 weeks (TC); cisplatin 80 mg/m(2) on day 1 plus gemcitabine 1000 mg/m(2) on days 1, 8 every 3 weeks (GP); and cisplatin 80 mg/m(2) on day 1 plus vinorelbine 25 mg/m(2) on days 1, 8 every 3 weeks (NP). RESULTS: The response rate, median survival time, and 1-year survival rate were 31.0%, 13.9 months, 59.2%, respectively, in IP; 32.4%, 12.3 months, 51.0% in TC; 30.1%, 14.0 months, 59.6% in GP; and 33.1%, 11.4 months, 48.3% in NP. No statistically significant differences were found in response rate or overall survival, but the non-inferiority of none of the experimental regimens could be confirmed. All the four regimens were well tolerated. CONCLUSION: The four regimens have similar efficacy and different toxicity profiles, and they can be used to treat advanced NSCLC patients.  相似文献   

16.
PURPOSE: This randomized, multicenter, phase III trial was conducted to compare the tolerability of gemcitabine plus cisplatin (GP) vs. gemcitabine plus carboplatin (GC) in chemonaive patients with stage IIIb and IV non-small cell lung carcinoma (NSCLC). Secondary objectives were to evaluate response, duration of response, time to progressive disease (TTPD), and survival. PATIENTS AND METHODS: Eligible patients were required to have stage IIIb or IV NSCLC, no previous chemotherapy, Karnofsky performance status of at least 70, bidimensionally measurable disease, and age 18-75 years. Randomized patients in both arms were given gemcitabine 1200 mg/m(2) on days 1 and 8, followed on day 1 by cisplatin 80 mg/m(2) (GP) or carboplatin AUC=5 (GC). Treatment cycles were repeated every 21 days for a maximum of six cycles, or until disease progression or unacceptable toxicity occurred. RESULTS: Enrolled patients in both arms, 87 in GP and 89 in GC, were well balanced for demographics and disease characteristics. Dose intensity was 93.8 and 92.7% for gemcitabine in GP/GC arms, respectively; 97.7% for cisplatin and 99.9% for carboplatin. Patients with at least one grade 3/4 toxicity excluding nausea, vomiting or alopecia, were 44% in GP arm and 54% in GC arm. The only significantly different toxicities were, nausea and vomiting in GP and thrombocytopenia in GC group. The overall response rates, median TTPD, response duration and survival were, 41/29%, 5.87/4.75 months, 7.48/5.15 months, and 8.75/7.97 months for GP and GC arms, respectively. CONCLUSION: GP and GC are effective and feasible regimens for advanced NSCLC, and are comparable in efficacy and toxicity. GC may offer acceptable option to patients with advanced NSCLC, especially those who are unable to receive cisplatin.  相似文献   

17.
铂类为基础的3种化疗方案治疗晚期非小细胞肺癌   总被引:1,自引:0,他引:1  
目的 :观察 3种常用的抗癌药 (长春瑞滨、吉西他滨和紫杉醇 )联合铂类方案治疗晚期非小细胞肺癌的疗效及毒副反应。方法 :经组织学证实的 70例晚期非小细胞肺癌患者 ,分为 3组化疗。PC组 :紫杉醇 135mg/m2 ,静滴 3小时 ,第 1天 ,卡铂按药时曲线下面积 (AUC)等于 5计算 ,静滴 ,第 2天 ,每 3周为一周期 ;NP组 :长春瑞宾2 5mg/ (m2·d)静注 ,第 1、8天 ,顺铂 75mg/m2 静滴 ,第 1天 ,每 3周为 1周期 ;GP组 :吉西他滨 10 0 0mg/ (m2 ·d)静滴 30分钟第 1、8、15天 ,顺铂 75mg/m2 静滴第 1天 ,每 4周为一周期。连续应用 2周期后评价疗效及不良反应。结果 :PC组 (n =2 4 )总有效率 (10 / 2 4 ) 4 1.7% ;NP组 (n =2 5 )总有效率 (10 / 2 5 ) 4 0 % ;GP组 (n =2 1)总有效率 (9/ 2 1) 4 2 .9% ,各组间比较总有效率差异无统计学意义 (P >0 .0 5 ) ;毒副反应方面 ,3组白细胞下降及贫血相近 ,NP组血小板降低较其他两组轻 ,PC组胃肠道反应及肾功能损害较其他两组轻 ,但外周神经毒性较其他两组多。结论 :作为晚期非小细胞肺癌一线治疗 ,PC、NP、GP 3种方案疗效相似 ,但 3种方案毒性存在差异 ,应根据患者个体情况进行选择。  相似文献   

18.
CASE: A 56-year-old Japanese man who was suffering from dry cough and right neck mass visited our hospital. Chest X-ray revealed a lung mass shadow in the lower left lung field. We diagnosed it as an advanced large cell carcinoma after conducting transbronchial lung biopsy and neck lymphnode biopsy. A right neck mass enlarged after three chemotherapy regimens of carboplatin and vinorelbine for first-line, docetaxel for second-line, and TS-1 and cisplatin for third-line. Finally, cisplatin (80 mg/m(2), day 1) and gemcitabine (800 mg/m(2), day 1, 8) were administered as fourth-line therapy. Partial response was observed after completing four chemotherapy cycles. CONCLUSION: In this case, the fourth-line chemotherapy, consisting of cisplatin and gemcitabine, proved effective for refractory NSCLC. Further research should be conducted regarding third-line chemotherapy for NSCLC patients with good performance status.  相似文献   

19.
PURPOSE: To determine the maximally tolerated dose (MTD) of gemcitabine administered at a fixed dose-rate of 10 mg/m(2) per min in combination with fixed dose carboplatin, to evaluate the toxicity of this regimen and to determine the pharmacokinetics of plasma gemcitabine. METHODS: Patients with advanced stage non-small-cell lung cancer (NSCLC) received carboplatin (AUC 5) on day 1 followed by gemcitabine at a fixed dose rate of 10 mg/m(2) per min in escalating durations of infusion on days 1 and 8 every 21 days. Pharmacokinetic sampling was obtained on day 1, cycle 1 of treatment. RESULTS: A total of 15 patients received carboplatin and gemcitabine in cohorts of three to six patients at three dose levels. The doses of gemcitabine studied were 600, 750, and 900 mg/m(2). The MTD was reached at 900 mg/m(2). Dose-limiting toxicities were thrombocytopenia and liver failure, and with repeated dosing neutropenia was commonly observed. The recommended phase II dose of gemcitabine was 750 mg/m(2). Partial responses were observed at 600 and 750 mg/m(2) of gemcitabine. Plasma gemcitabine did not reach steady state except in one patient with the durations of infusion studied. Plasma concentrations, however, were above 10 micro mol/l between 20 and 90 min in all patients. CONCLUSIONS: Gemcitabine administered as a 75-min infusion at a fixed dose rate of 10 mg/m(2)/min on days 1 and 8 in combination with carboplatin on day 1 every 21 days is tolerable and active in NSCLC. Pharmacokinetic studies demonstrated that the target plasma gemcitabine concentration above 10 micro mol/l was achieved. Further studies are warranted to compare this regimen against standard regimens of carboplatin and gemcitabine.  相似文献   

20.
目的:评价每周应用卡铂与吉西他滨治疗晚期非小细胞肺癌(NSCLC)的疗效及安全性。方法:52名未接受过化疗治疗的,所患NSCLC体积可测定的患者被纳入。患者接受吉西他滨(1 000mg/m2 d1,8)及卡铂(AUC=2 d1,8)治疗,每三周为一个化疗疗程。结果:缓解率为33%(17/52)。疾病进展时间为17.2周,中位生存时间43.6周。1年生存率42.3%。主要毒副反应为血液系统毒性:3级或4级中性粒细胞减少(35%)及血小板减少(29%)。无其他严重毒副反应。结论:一线应用卡铂联合吉西他滨每周给药治疗晚期NSCLC,耐受性好,有较好临床效果。  相似文献   

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