不同剂型紫杉醇联合顺铂治疗晚期非小细胞肺癌的效果分析

目的 探讨不同剂型紫杉醇联合顺铂治疗晚期非小细胞肺癌（NSCLC）的临床疗效。方法选取本院2014年1月至2016年1月收治的晚期NSCLC患者共90例，根据紫杉醇剂型分为3组，其中紫杉醇组31例接受紫杉醇联合顺铂治疗，脂质体紫杉醇组27例接受脂质体紫杉醇联合顺铂治疗，白蛋白结合型紫杉醇组32例接受白蛋白结合型紫杉醇联合顺铂治疗，2个周期后采用RECIST 1.0评价各组的近期疗效，采用NCI-CTC AE（3.0版）分级标准评价毒副作用，根据随访资料比较3组的无进展生存期（PFS）。结果全组患者均可评价近期疗效。紫杉醇组、脂质体紫杉醇组和白蛋白结合型紫杉醇组的有效率分别为16.1％、18.5％和21.9％，疾病控制率分别为87.1％、92.6％和93.8％，三组有效率和疾病控制率的差异均无统计学意义（P＞0.05）；紫杉醇组、脂质体紫杉醇组和白蛋白结合型紫杉醇组的中位PFS分别为9.0、10.0和12.0个月，差异无统计学意义（P＞0.05）；脂质体紫杉醇组和白蛋白结合型紫杉醇组的恶心呕吐和肌肉／关节痛的总发生率分别为44.4％和34.4％、18.5％和12. 5％，均低于紫杉醇组，差异有统计学意义（P＜0.05）。结论 不同剂型紫杉醇联合顺铂治疗晚期NSCLC的疗效相当，但脂质体紫杉醇和白蛋白结合型紫杉醇的毒副反应较轻，可作为年龄较大、一般状况较差患者的治疗方案。

Effects analysis of different dosage forms of paclitaxel plus cisplatin in the treatment of advanced non-small cell lung cancer

Objective To explore the clinical efficacy of different forms of paclitaxel combined with cisplatin in the treatment of advanced non-small cell lung cancer（NSCLC）. Methods From January 2014 to January 2016，90 patients with advanced NSCLC treated in our hospital were assigned to 3 groups： 31 cases in paclitaxel group treated with paclitaxel combined with cisplatin， 27 cases in liposome paclitaxel group treated with liposome paclitaxel combined with cisplatin and 32 cases in albumin bound paclitaxel group treated with albumin bound paclitaxel combined with cisplatin. Response to chemotherapy was assessed by RECIST criteria 1.1 and toxicity was evaluated according to National Cancer Institute Common Toxicity Criteria 4.0. The clinical follow-up data from chemotherapy were investigated for comparison of median progression free survival（PFS）among different groups. Results All patients were available for evaluation. The effective rates were 16.1％， 18.5％ and 21.9％ and disease control rates were 87.1％， 92.6％ and 93.8％ in paclitaxel group， liposome paclitaxel group and albumin bound paclitaxel group，respectively. There were no significant difference among three groups（P＞0.05）. The median PFS of paclitaxel group， liposomal paclitaxel group and albumin bound paclitaxel group were 9.0， 10.0 and 12.0 months，and the difference was not statistically significant （P＞0.05）. The total incidence rates of nausea and vomiting were 44.4％ and 34.4％ and total incidence rates of muscle／joint pain were 18. 5％ and 12.5％ in liposomal paclitaxel group and albumin bound paclitaxel group，significantly lower than those in the paclitaxel group（P＜0.05）. ConclusionThere were similar efficacies in NSCLC patients receiving different forms of paclitaxel plus cisplatin. The toxicity and side effects of liposomal paclitaxel and albumin bound paclitaxel are relatively mild，may serving as a treatment candidate for patients with a larger age and poor general condition.