NP与GP方案治疗晚期非小细胞肺癌68例疗效分析

为了评价NP和GP方案治疗晚期非小细胞肺癌的疗效和不良反应。将1999年12月2日～2004年5月2日收治的68例非小细胞肺癌(nonsmallcelllungcancer,NSCLC)患者随机分为两组,分别应用NP和GP方案治疗。NP方案:长春瑞滨(NVB)25mg/m2,d1、d8;顺铂(DDP)50mg,d3～d5。GP方案:健择(Gemcitabine)1000mg/m2,d1、d8;DDP50mg,d3～d5,两种方案均21d为1个周期,至少治疗2个周期。结果为NP组35例,无CR,PR17例(48.6%),SD13例(37.1%),PD5例(14.3%),总有效率为48.6%(17/35),临床受益率85.7%(30/35)。GP组33例,CR1例(3.0%),PR14例(42.4%),SD13例(39.4%),PD5例(15.2%),总有效率为45.5%(15/33),临床受益率84.8%(28/33)。NP组和GP组中位进展时间分别为3.2和3.3个月,初治优于复治(NP组60%vs33%,GP组52.6%vs35.7%)。剂量限制性毒性主要为骨髓抑制,NP组和GP组白细胞及血小板下降的发生率分别为80%、22.9%和51.5%、51.5%。NP组静脉炎及胃肠道反应较GP组重(31.4%vs6.1%和57.1%vs45.5%)。初步研究结果提示,NP和GP方案治疗晚期NSCLC均安全有效,疗效相当,不良反应均可耐受。

Vinorelbine plus cisplatin versus gemcitabine plus cisplatin in treatment of patients with advanced non-small cell lung cancer

The objective of this study was to compare the efficacy and toxicity of vinorelbine plus cisplatin (NP) and gemcitabine plus cisplatin (GP) combinations in the treatment of advanced non-small cell lung cancer (NSCLC). From December 1999 to May 2004, a total of 68 patients with advanced NSCLC were randomized to receive vinorelbine 25mg/m2 on days 1,8 infusion and cisplatin 50mg on days 3,4,5 or gemcitabine 1 000 mg/m~2 on day 1,8 infusion and cisplatin 50mg on days 3,4,5. Both regimens were repeated every 3 weeks. A total of 68 patients (35 patients in group NP, 33 patients in group GP), were enrolled. The median time to progression was 3.2 months for group NP and 3.3 months for group GP. The overall response rate for group NP was 48.6%,with no complete response (CR),48.6% of partial response (PR), 37.1% of stable disease (SD), 14.3% of progression of disease (PD), and the benefit rate was 85.7%,and in group GP, the overall response rate was 45.5%,with 3.0% of CR,42.4% of PR,39.4% of SD, 15.2% of PD,and the benefit rate was 84.8%.The response rate was higher in previously untreated cases than in treated cases (60% vs 33.3% in group NP, and 52.6% vs 35.7% in group GP). The incidences of neutropenia and thrombocytopenia were 80% and 22.9% in group NP, and 51.5% and 51.5% in group GP, respectively. Phlebitis (31.4% vs 6.1%) and nausea/vomiting (57.1% vs 45.5%) were more severe in group NP. In conclusion, both NP and GP combined chemotherapy produce similar efficacy and are well tolerated in patients with advanced non-small cell lung cancer.