香菇多糖联合吉西他滨与顺铂治疗非小细胞肺癌效果

目的探讨应用香菇多糖联合吉西他滨与顺铂治疗晚期非小细胞肺癌（NSCLC）的效果。方法对98例经病理或细胞学检查证实的晚期NSCLC的初治病人给予联合化疗，随机分为香菇多糖、吉西他滨和顺铂（GPL）组与吉西他滨和顺铂（GP）组。GP组吉西他滨1000mg／m^2静脉注射，第1、8天，顺铂25mg／m^2加入生理盐水250mL中静滴，第1～3天；21d为1个周期，每例治疗不超过6个周期。GPL组在GP组治疗的基础上，将香菇多糖1mg加入50g／L的葡萄糖注射液250mL中静滴，每周2次，连用8周，并比较两组疗效。结果两组有效率、1年生存率、中位生存期比较差异无显著性。最常见的毒副作用为恶心呕吐，GPL和GP组的Ⅲ＋Ⅳ度反应发生率分别为4．08％和55．10％，两组比较差异有显著性（χ^2=30．620，P〈0．05）；其余毒副作用轻微，可耐受。结论香菇多糖联合吉西他滨与顺铂治疗晚期NSCLC与单纯化疗相比疗效相似，而毒副作用轻，安全可行，值得临床推广应用。

THERAPEUTIC EFFECT OF COMBINED LENTINAN, GEMCITABINE AND CISPLATIN IN THE TREATMENT OF ADVANCED NON-SMALL CELL LUNG CANCER

Objective To evaluate the therapeutic effect of lentinan, gemcitabine and cisplatin in the treatment of advaneed non-small cell lung cancer （NSCLC）. Methods Ninety-eight advanced NSCLC patients confirmed by pathology or cytology received combined chemotherapy. The patients were randomly divided into two groups. The GDL group received combined therapy of Gemcitabine, Diamminedichloroplatinum and Lentinan, the GD group received Gemcitabine and Diamminedichloroplatinum. In GD group, the patients were given intravenous injection of Gemcitabine （1 000 mg/m^2） on the 1st and 8th day and venous dripping of Diamminediehloroplatinum （25 mg/m^2） in 250 mL of normal saline during the first three days. Each patient received not more than six cycles with 21 days in each cycle. In the GDL group, in addition to the same therapy as in the GD group, intravenous dripping of 1 mg Ientinan in 250 mL of 50 g/L glucose was administered, twice a week for 8 weeks. The therapeutic outcomes were compared between the two groups. Results There were no significant differences in the response rate,one-year survival rate and median survival time between the two groups. The commonly seen toxic and side effects of the drugs were nausea and vomiting. The incidence of grade Ⅲ and IV adverse reaction in groups GDL and GD were 4.08% and 55. 10%, respectively, the difference was statistically significant （χ^2=30. 620,P〈0.05）. Other side effects were minimal and endurable. Conclusion The combined therapeutic effect of Gemcitabine, Diamminedichloroplatinum and Lentinan for advanced NSCLC was similar to that of simple chemotherapy, but with less side effects, safe and feasible, which is worth promoting for clinical use.