NP与TP及GP方案治疗晚期非小细胞肺癌的近期疗效观察

目的比较长春瑞滨(vinorelbine,NVB)加顺铂(cisplatin,DDP)、紫杉醇(pacli-axe,PTX)联合DDP与吉西他滨(gemcit-abine,dFdC)加DDP分别组成的3种联合方案(NP、TP和GP)治疗晚期非小细胞肺癌(non-smallcelllungcarcinoma,NSCLC)的近期疗效和不良反应。方法NP组102例,TP组133例,GP组100例。NP组NVB25mg/m2,d1、d8;DDP70mg/m2分天给药。TP组PTX135mg/m2,d1;DDP总量90mg/m2,d2~d6。GP组dFdC1000mg/m2,30min,d1、d8;DDP总量90mg/m2,d2~d6。对临床疗效和不良反应进行对比观察。结果NP组有效率(RR)为42.16%,TP组为45.11%,GP组为47.00%。3组RR比较差异无统计学意义,P>0.05。不良反应均以骨髓抑制、脱发及恶心呕吐为主,均可耐受。GP组血小板降低较其他2组严重,P<0.05。结论NVB、dFdC或PTX联合DDP治疗晚期NSCLC具有较好的耐受性和临床疗效,不良反应可以耐受。应根据患者特点,尽可能选择个体化治疗。

Clinical observation of NP, TP and GP in treating advanced non-small cell lung cancer

OBJECTIVE:To observe the curative efficacy and side effect of vinorelbine or gemcitabine, paclitaxel combined with cisplatin in treating advanced non-small cell lung cancer (NSCLC). METHODS: There are 335 advanced NSCLC patients totally. 102 in NP (vinorelbine plus cisplatin) group,133 in TP(paclitaxel plus cisplatin) group and 100 in GP (gemcitabine plus cisplatin) group. NP group: vinorelbine 25 mg/m2,d_1,d_8,cisplatin 70 mg/m2,d_1-d_3;TP group:paclitaxel 135 mg/m2,d_1,cisplatin 90 mg/m2 in d_2-d_6. GP group: gemcitabine 1 000 mg/m2,30 min, d_1,d_8,cisplatin 90 mg/m2 in d_2-d_6. the efficacy and side effects were analyzed after at least two cycles of chemotherapy. RESULTS: The respons rates(CR PR) were 42.16% in the NP group; 45.11% in the TP group and 47.00% in the GP group. No significant statistical difference was found between the three groups, P>0.05. The major side effects were myelo suppression, alopecia and nausea/vomiting in the three groups. All adverse reactions were tolerable. The major cytotoxicity of GP group was fatigue and neurotoxicity, P<0.05. CONCLUSION: NP, GP and TP regimens with manageable toxicity have good anti-tumor activity on advanced NSCLC. As the different side effects in NP, TP and GP group, the regimen should be chosen according to the condition of patient.