多西他赛联合顺铂后续用吉西他滨治疗NSCLC临床观察

目的比较晚期非小细胞肺癌(NSCLC)先给予两种多西他赛联合顺铂的治疗方案后分别再连续性给予吉西他滨进行治疗的效果及其不良反应的差别。方法 84例NSCLC患者(ⅢB/Ⅳ),随机分为两组,A组(n=43)为:第1天给予多西他赛75 mg/m2和75 mg/m2顺铂,3周为一个疗程,重复3个周期;3个治疗周期结束后的第1,8天再给予吉西他滨1000 mg/m2静脉滴注,3周为一个治疗周期,重复3个周期。B组(n=41)为:第1,8,15天给予多西他赛25 mg/m2和顺铂25 mg/m2静滴,4周为一个周期,重复3个周期;3个治疗周期结束的第1,8天给予吉西他滨1000 mg/m2静脉滴注,3周为一个治疗周期,重复3个周期。结果 A组的最终病例为43例,B组为40例。两组患者完全缓解(CR)均为0例,A组方案中PR 22例,SD 12例,有效率为51.2%,B组中PR 20例,SD 15例,有效率为50%。两组中性粒细胞Ⅲ/Ⅳ度减少分别是A组为55.1%和B组12.5%,B组不良反应率明显低于A组。结论多西他赛联合顺铂治疗NSCLC后再给予吉西他滨单药的连续性化疗方案疗效显著,多西他赛联合顺铂3周治疗后续用吉西他滨的治疗方案与每周方案疗效相似,但每周方案治疗的毒性反应明显低于三周治疗方案。

Clinical Observation on Docetaxel with Cisplatin Followed by Gemcitabine in Patients with Advanced Non-Small-Cell Lung Cancer

Objective To determine the activity and toxicity of two sequential chemotherapy regimens(docetaxel and cisplatin followed by gemcitabine) in the treatment of advanced non-small-cell lung cancer(NSCLC).Methods Eighty-four patients with stage ⅢB/Ⅳ NSCLC were randomly divided into two groups.Group A(n=43) treated with three cycles of 75 mg/m2 cisplatin plus 75 mg/m2 docetaxel on day 1 every 21 days;Group B(n=41) with three cycles of 25 mg/m2 cisplatin plus 25 mg/m2 docetaxel on days 1,8 and 15 every 28 days;Then followed by three cycles of 1000 mg/m2 gemcitabine on days 1 and 8 every 3 weeks in both groups.Results There were no CR in the 83 cases(the final patients A was 43 and B was 40).There were 22 PR,12 SD in group A,and 20 PR,15 SD in group B.The overall response rates were 51.2% in group A and 50% in group B.Grade Ⅲ/Ⅳ neutropenia was the main observed toxicity(55.1% in group A and 12.5% in group B).Conclusion The sequential approach of cisplatin plus docetaxel followed by single-agent gemcitabine is feasible.Weekly administration of platinum-docetaxel is associated with an improved safety profile and similar efficacy to the conventional three-weekly schedule.