GP 方案和吉非替尼单药一线治疗非小细胞 肺癌疗效比较

 目的　对比分析以铂类为基础的GP(吉西他滨+ 顺铂) 联合化疗和单药吉非替尼( IRESSA) 一 线治疗ⅢB2 Ⅳ期非小细胞肺癌的近期疗效和毒副作用。方法　60 例ⅢB～ Ⅳ期从未接受过化疗的非小 细胞肺癌患者中,单用吉非替尼治疗26 例,GP 方案治疗34 例。吉非替尼组为吉非替尼250 mg/ d ; GP 组为吉西他滨1 250 mg/ m2 ,第1 ,8 天,顺铂75 mg/ m2 ,第1 天。每三周为一周期,两周期后评价客观疗 效及不良反应。结果　两组总有效率吉非替尼组26. 9 %(7/ 26) ,GP 组29. 4 %(10/ 34) , P > 0. 05 ;疾病控 制率吉非替尼组76. 9 %(20/ 26) ,GP 组50. 0 %(17/ 34) , P < 0. 05 。GP 组主要存在骨髓抑制和胃肠道反 应毒性( P < 0. 05) ,吉非替尼组的毒性反应主要为皮疹和腹泻。结论　GP 方案和吉非替尼单药一线治 疗非小细胞肺癌(NSCLC) 可获得一致的客观有效率,但吉非替尼单药的疾病控制率显著高于GP 组,且 其毒副反应较GP 组轻微,患者均可完全耐受。吉非替尼单药口服可考虑作为治疗晚期化疗难耐受的 NSCLC 患者的一线方案。

Comparison of GP Regimen and Gef itinib in First Line Treatment of Advanced Non2small Cell Lung Cancer

Objective 　Analyze const rastively the clinical efficacy and toxicity of GP ( Gemcitabine + Cispla2 tin) regimen and single agent Gefitinib in f rist line t reatment of ⅢB～ Ⅳstage non2small cell lung cancer (NSCLC) . Methods 　Sixty cases with stage ⅢB～ ⅣNSCLC pathologically proved were enrolled in this study. Oral Gefitinib 250mg daily were given to twenty2six cases ; the other thirty2four cases were t reated with Gemcitabine ( GEM ,1250 mg/ m2 ) on d 1 and d 8 and Cisplatin (DDP ,75 mg/ m2 ) on d1. Every three weeks (21days) as a cycle. The efficacy and adverse effect s were evaluated af ter two cycles of t reatment . Results 　The overall response rate (ORR) of single agent Gefitinib group was 26. 9 %(7/ 26) ,and that of combined GP group was 29. 4 %(10/ 34) ; there is no statistically significant difference ( P > 0. 05) . The clinical disease cont rol rate of Gefitinib group was 76. 9 %(20/ 26) ,and that of GP group was 50. 0 %(17/ 34) ; the difference was significant ( P < 0. 05) . The main toxicities included the alimentary t ract reaction and bone marrow depression were exist in combine GP group ; The Major toxicity in IRESSSA group is skin rash and diarrhea. Conclusion 　Gefitinib and GP regimen for advanced NSCLC have similar response rate ( P > 0. 05) . The former can get more clinical disease cont rol rate , and has lower toxicity. Gefitinib may be accepted as first line in the t reatment of patient s with bad constitution who is untolerable for chemotherapy.