紫杉醇联合奥沙利铂或顺铂治疗晚期非小细胞肺癌疗效观察

目的比较紫杉醇联合奥沙利铂或顺铂治疗晚期非小细胞肺癌（NSCLC）的疗效和毒性反应。方法将52例初治的NSCLC患者（ⅢB期或Ⅳ期,ECOG评分0～2分,各脏器功能及骨髓造血功能良好）随机分为两组：紫杉醇联合顺铂（TP）组25例,给予紫杉醇135 mg/m2,d1;顺铂25 mg/m2,d1～d3;紫杉醇联合奥沙利铂（TO）组27例,紫杉醇用法同顺铂组;奥沙利铂125 mg/m2,d1。两组均静脉滴入,每21 d为1个周期,每个患者至少给予2个周期。完成2个周期化疗后评价疗效和毒副反应。结果 TO组和TP组有效率分别为37.0%和40.0%（P〉0.05）;Ⅲ～Ⅳ度白细胞减少发生率分别为11.1%和36.0%（P〈0.05）,Ⅲ～Ⅳ度胃肠道反应率分别为14.8%和44.0%（P〈0.05）,Ⅰ＋Ⅱ度神经毒性发生率分别59.2%和20.0%（P〈0.05）。结论紫杉醇联合奥沙利铂或顺铂是治疗晚期NSCLC的有效方案,两方案的近期疗效相似,但紫杉醇联合奥沙利铂方案的血液学毒性及消化道不良反应较轻。

Curative effects of paclitaxel combined with oxaliplatin or cisplatin on advanced non-small cell lung cancer

Objective To make comparison of curative effects and toxic reaction on advanced non-small cell lung cancer(NSCLC)between the treatment by paclitaxel(PTX)combined with oxaliplatin and that by PTX combined with cisplatin.Methods Fifty two patients with advanced NSCLC and receiving initial treatment(in Ⅲ B /Ⅳ stage,with ECOG score of 0-2 points and with fine organ function and hematopoietic function)were randomly divided into two groups.In the paclitaxel-cisplatin group(25 cases,TP group),each patient received 135 mg/m2 paclitaxel in d 1 and 25 mg/m2 cisplatin from d 1 to d 3.In the paclitaxel-oxaliplatin group(27 cases,TO group),each one received the same dosage of paclitaxel as the TP group and 125 mg/m2 oxaliplatin in d 1.Both groups were treated by intravenous drip with each 21 d as a period.Every patient received at least 2 periods.After two periods of chemotherapy,the curative effects and toxic reaction were assessed.Results The effective rate of TO and TP group was 37.0 % and 40.0%,respectively(P>0.05).The incidence of aleucocytosis in Ⅲ to Ⅳ degree was 11.1% and 36.0 %,respectively(P<0.05).The incidence of gastrointestinal reaction in Ⅲ to Ⅳ degree was 14.8% and 44.0%,respectively(P<0.05).The incidence of neurotoxicity inⅠ+Ⅱdegree was 59.2% and 20.0%,respectively(P<0.05).Conclusion Paclitaxel combined with oxaliplatin or cisplatin are effective in the treatment of advanced NSCLC.The short term curative effects of both methods are similar,but the hematological toxicity and adverse reaction in alimentary tract caused by the combination of paclitaxel and oxaliplatin are less than those caused by the combination of paclitaxel and cisplatin.