长春瑞滨和顺铂联合西乐葆一线治疗晚期非小细胞肺癌

目的比较长春瑞滨和顺铂（NP）方案联合西乐葆与NP方案治疗晚期非小细胞肺癌（non-small-cell lungcancer，NSCLC）的疗效和安全性。方法65例ⅢB/IV期NSCLC患者随机分为A组和B组。A组32例，化疗方案NP方案联合西乐葆，长春瑞滨25 mg/m^2第1、8天静脉注射，顺铂75 mg/m^2第1、2天静脉滴注，西乐葆400 mg2次/日，第1-12天口服，21 d为一个周期；B组33例，化疗方案为NP方案，用法同A组。结果A组与B组有效率分别为35.5%和26.7%（P=0.457），临床受益率分别为87.1%和66.7%（P=0.058），1年生存率分别为58.1%和36.7%（P=0.094），中位生存期分别为12个月和9.2个月（P=0.062）。而36例肺腺癌中，A组1年生存率为64.7%，显著高于B组的26.3%（P=0.021）；且A组中位生存期为12.5个月，明显高于B组的8.7个月（P=0.033）。A组恶心/呕吐的发生率为67.7%，明显高于B组的40.0%（P=0.03），而白细胞下降、恶心呕吐、脱发、静脉炎、神经毒性和血小板减少等副作用之间差异无统计学意义。结论NP方案联合西乐葆治疗晚期NSCLC有效，安全性好。肺腺癌的1年生存率及中位生存期均显著高于NP方案组。

First-line regimen of Vinorelbine and Cisplatin(NP) combined with cyclooxygenase-2 inhibitor celecoxib in advanced non-small-cell lung cancer

Objective To investigate efficacy and safety of first-line regime of Vinorelbine and Cisplatin(NP) combined with cyclooxygenase-2 inhibitor celecoxib in treating advanced non-small-cell lung cancer(NSCLC) patientsMethods Sixty five NSCLC patients were randomly assigned to group A and group B.In the group A,32 patients were treated with Vinorelbine 25 mg/m2 iv on days 1 and 8,Cisplatin 75 mg/m2 iv on day 1 and Celecoxib 400 mg bid orally on days 1 to 12,repeated every 21 days.In group B,33 cases were treated with NP regimen only.Results Compared with group B,the response rate in group A was 35.5% vs 26.7%(P=0.457),clinical benifit rate was 87.1% vs 66.7%(P=0.058),one-year survival rate was 58.1% vs 36.7%(P=0.094) and median survival time was 12 months vs 9.2 months(P=0.062)respectively.In 36 cases of lung adenocarcinoma,one-year survival rate and median survival time were significantly higher in group A than in group B(64.7% vs.26.3%,P=0.021)and(12.5 months vs 8.7 months,P=0.033) respectively.Nausea/vomiting occurred significantly more frequently in gruop A than in gruop B(67.74% vs 40.0%,P=0.030).Other side-effects had no statistical difference between two groups.Conclusion The regimen of NP combined with COX-2 inhibitor Celecoxib is effective and tolerable as the first-line treatment in advanced NSCLC.The one-year survival rate and median survival time were significantly higher in those treated with NP plus Celecoxib.