吉西他滨联合奈达铂治疗老年晚期非小细胞肺癌的临床观察

目的 观察吉西他滨( GEM)联合奈达铂(NDP)治疗老年晚期非小细胞肺癌( NSCLC)的效果及药物毒性反应,分析、评价GEM联合NDP治疗老年晚期NSCLC的临床效果.方法 选择我院2009年6月-2011年6月收治的70例经病理或细胞学证实的晚期NSC LC患者,将其随机分为2组:观察组35例,采用GEM+ NDP方案；对照组35例,采用GEM+顺铂(DDP)方案；治疗2周期后进行疗效评估.结果 观察组有效率为40.0％,中位生存期为8.7月,1年生存率为33.5％；而观察组有效率为42.8％,中位生存期为9.2月,1年生存率为32.7％；尽管观察纽有效率高于对照组,但两组差异无显著性(P＞ 0.05).对照组白细胞减少、血红蛋白减少及血小板减少发生率分别为54.3％、34.2％、57％,而观察组发生率分别为57％、42.8％、62.9％,尽管观察组骨髓抑制发生率较对照组稍高,但二者差异无显著性(P＞ 0.05)；GN组胃肠道反应发生率较GP组明显低,具有统计学意义(P＜0.05)；两组肝肾功能损害发生率较低,差异无显著性(P＞ 0.05).结论 以铂类为基础的联合化疗疗效肯定,GEM联合NDP与GEM联合DDP疗效相当,但NDP胃肠道反应较低,肝肾毒性较低,患者耐受性及依从性较高.

Gemcitabine combined with nedaplatin for elderly patients with advanced non-small cell lung cancer

Objective To explore the efficacy and toxic reaction of gemcitabine （ GEM ） combined with nedaplatin （ NDP ） in the treatment of elder patients with advanced non-small cell lung cancer （ NSCLC ）. Methods 70 patients with advanced NSCLC comfirmed by pathology or cytology who had been treated from June 2009 to June 2011 were included in this study. The patients were randomly assigned to receive GEM plus either NDP （ 35 patients, study group ）, or DDP （ 35 patients, control group ）. The efficacy was assessed after two cycles of treatment. Results The total effectiveness rate, median survival duration, and one-year survival rate did not differ significantly between the study group and the control group （ 40.0% vs. 42.8%, 8.7 months vs. 9.2 months, and 33.5% vs. 32.7%, P〉 0.05 ）. The incidence rates of leukopenia, decreased haemoglobin level, and thrombocytopenia were 54.3%, 34.2%, and 57% in the control group and 57%, 42.8%, and 62.9% in the study group, respectively. There was no statistical significance （ P 〉 0.05 ）. The incidence rate of gastrointestinal reactions was significantly lower in the study group than in the control group （ P〈 0.05 ）. The rate of liver and kidney function damage was lower, with no significant difference between the two groups （ P〉 0.05 ）. Conclusions Platin-based chemo- therapy is efficacious in the treatment of advanced NSCLC. GEM combined NDP has a similar efficacy with GEM plus DDP. NDP has lower gastrointestinal reaction, lower hepatorenal toxicity, and higher tolerance and compliance in patients.