改进的紫杉醇联合顺铂方案治疗晚期非小细胞肺癌的临床观察

目的 为比较紫杉醇联合顺铂改进的3周方案与传统3周方案治疗晚期NSCLC的疗效、毒副反应及1年生存率。方法75例经组织学或细胞学确诊的Ⅲb或Ⅳ期NSCLC患者,随机分为两组,分别接受改进方案（A组）和传统3周方案（B组）化疗。2周期后评价疗效与毒副反应,并随访1年生存率。结果A组无CR,A组总有效率为47．9％（18／37）;B组CR1例,总有效率为52．6％（20／38）。总有效率两组差异无显著性（P〉0．05）,两组1年生存率分别为38．2％和35．6％。两组差异无显著性（P〉0．05）。主要毒副反应为恶心、呕吐、骨髓抑制、脱发、周围神经毒性、肝功能受损、心脏毒性等。A、B组差异无显著性（P〉0．05）。关节肌肉疼痛A组32．4％;B组84．2％,两组差异有显著性（P〈0．05）。结论紫杉醇联合顺铂改进的3周方案治疗NSCLC与传统3周方案相比,疗效相似,但血液学毒性明显下降,耐受性好。

Clinical analysis of modified paclitaxel combined cisplatin as chemotherapy for advanced non-small cell lung cancer

Objective To compare the effect and toxic of modified and standard 3 -weeks' paclitaxel /cisplatin as first line chemotherapy for advanced NSCLC. Methods 75 patients with stage Ⅲ b or Ⅳ NSCLC (proven by histology or cytology ) were randomly divided into two groups, modified (A) and standard (B)chemotherapy. The effect and toxicity were assessed after two cycles and one-year survival rate was followed up.Results There was no CR in A groups. The overall response rate was 47. 9%; There was 1 CR in B groups. the overall response rate was 52. 6%. The one -year survival rate were 38. 2% and 35.6% in group A and B, respectively. There were no significant difference about the overall response rate ( P ＞ 0. 05 ) and one-year survival rate(P ＞ 0.05) between group A and B. The major adverse reaction were nausea, emesia, myelosuppression,alopecie, peripheral nerve neurotoxicity, Hepatic function damage, cordis-toxicity. There were no significant difference about the overall response rate ( P ＞ 0. 05 ) between group A and B. The syntaxis and muscle pain were 32. 4% and 84. 2% in group A and B, respectively. There were significant difference about the overall response rate (P ＜ 0. 05) between group A and B. Conclusion In comparison with the standard 3-weeks' paclitaxel / cisplatin chemotherapy, the modified one has similar response rate but lower hematologic toxicity and thus it is well tolerated.