晚期非小细胞肺癌两种含铂新方案的临床近期疗效比较

目的　观察NP(长春瑞宾加顺铂 )方案和GP(吉西他宾加顺铂 )方案两种含铂方案治疗晚期非小细胞肺癌 (non -smallcelllungcancer,NSCLC)的近期疗效和毒副反应。方法　采用NP方案治疗晚期NSCLC2 5例 ,GP方案治疗 2 3例。结果　临床疗效 :GP组完全缓解 0例 ,部分缓解 8例 ,稳定 12例 ,进展 3例 ,有效率为 3 4 8% ;NP组完全缓解 0例 ,部分缓解 8例 ,稳定 13例 ,进展 4例 ,有效率为 3 2 0 %。两组有效率差异无统计学意义 (P =0 776 )。毒副反应 :GP组血小板减少明显 (P =0 0 0 9) ,NP组白细胞减少明显 (P =0 0 0 6 )。结论　NP方案和GP两种方案治疗晚期NSCLC均有效 ,两种方案疗效相似。两组均有血液毒性 ,GP方案以血小板减少为主 ,且有过敏现象 ;NP方案以白细胞减少为主 ,并有静脉炎和周围神经毒性。

Gemcitabine plus Cisplatin Compared with Vinorelbine plus Cisplatin for Advanced Non- Small - Cell Lung Cancer

Objective To assess the effectiveness and toxicity of the two platinum-containing chemotherapy in advanced non-small-cell lung cancer(NSCLC). Method 48 patients with stage IIIB (effusion and supraclavicular nodes) or IV documented NSCLC who were younger than 70 years of age were randomly assigned gemcitabine plus cisplatin(GP) or vinorelbine plus cisplatin(NP). Results No statistically significant differences in clinical efficacy were observed between the two chemotherapy regimens. The overall objective response rates were 34 8% in the GP arm and 32 0% in the NP arm ( P =0 776). Thrombocytopenia was significantly higher in the GP arm ( P =0 009) and leukopenia was significantly higher in the NP arm ( P =0 006). Conclusion The gemcitabine-cisplatin is similar to the vinorelbine-cisplatin in term of overall response rate and KPS. However, hematological toxicity and alopecia are more frequent and severe in the MVP regimen which therefore appears to be less tolerable than the VC regimen. The combination of vinorelbine and cisplatin may be considered as a reference treatment for future studies on the treatment of advanced NSCLC. Thrombocytopenia was significantly higher in the GP arm and leukopenia was significantly higher in the NP arm.