吉西他滨与紫杉醇分别联合顺铂治疗非小细胞肺癌的对比研究

目的对比吉西他滨与紫杉醇分别联合顺铂化疗初治非小细胞肺癌的疗效和不良反应。方法81例患者随机分为两组，吉西他滨组（GP）：吉西他滨1 000 mg／m² ，d₁，d₈，静脉滴注，顺铂30 mg／m² ，d₂～d₄，静脉滴注，28天为1周期。紫杉醇组（TP）：紫杉醇175mg/ m²，d₁，顺铂30 mg／m² ，d₂～d₄，静脉滴注，28天为1周期。结果GP组总有效率（CR+PR）45.0％（18/40），TP组43.2％（16/37），两组近期疗效差异无统计学意义（χ²=0.527，P=0.957）。GP组中位生存期为11月，1年生存率37.7%，而TP组为11月，31.7%，两组生存差异无统计学意义（χ2=0.140，P=0.708）。两组主要不良反应不同，GP组血小板减少症显著高于TP组，而TP组外周神经炎、恶心呕吐和肌痛显著高于GP组。结论吉西他滨与紫杉醇联合分次顺铂治疗非小细胞肺癌疗效相当，但吉西他滨的治疗相关不良反应较轻，可作为初治晚期非小细胞肺癌的一线方案。

Comparison of Gemcitabine and Paclitaxel Combined with Fractionation-dose Cisplatin in Treatment of Untreated Advanced Non-small Cell Lung Cancer

Objective To compare the therapeutic effects and side effects of gemcitabine and paclitaxel combined with fractionation-dose cisplatin in the treatment of untreated advanced non-small cell lung cancer (NSCLC)． Methods Eighty-one patients with untreated advanced NSCLC were randomized into two groups: gemcitabine plus cisplatin (GP) and paclitaxel plus cisplatin (TP). Patients in GP received regimen: GEM 1000 mg／m² , d₁, d₈, DDP 30 mg／m² , d₂～d₄, repeated every 28 days. Patients in TP receive regimen: PTX 175mg/ m², d1, DDP 30 mg／m² , d₂～ d₄, repeated every 28 days. Results Overall response rate was 45.0% (18/40) in GP and 43.2% (16/37) in TP. Response Rates were not significantly different in two groups (χ²=0.527, P=0.957). Median survival time and 1-year survival rate in GP were 11 months and 37.7%, respectively, while 11 months and 31.7% in TP. Overall survival were not significantly different in two groups (χ²=0.140，P=0.708). Side effects were different in two groups: thrombopenia was significantly higher in GP than that in TP, however peripheral neuritis, nausea and vomiting, and myosagia were significantly higher in TP than that in GP. Conclusion GP and TP had similar therapeutic efficacy, however, side effects in GP were much slighter than that in TP. We presumed GP could be used as first-line chemotherapy regimen in untreated advanced NSCLC．