紫杉醇+卡铂及吉西他滨+卡铂方案治疗晚期非小细胞肺癌的临床观察

目的 了解紫杉醇+卡铂(TP)及吉西它滨+卡铂(GP)方案治疗晚期非小细胞肺癌的近期疗效和副作用.方法 北京大学第一医院肿瘤化疗科2003年9月至2010年8月确诊的晚期非小细胞肺癌86例,TP、GP方案治疗各43例.至少治疗2周期或以上.TP组:紫杉醇150 mg/m2,第1天;卡铂300 mg/m2,第1天,21 d为1个周期.GP组:吉西它滨1000 mg/m2,第1、8天;卡铂300 mg/m2,第1天,21 d为1个周期.对临床疗效和毒副反应进行对比观察.结果 TP组和GP组患者有效率(CR+PR)分别为44.2%及39.5%,疾病控制率(CR+PR+SD)为81.4%及74.4%,中位进展期为4.6个月及4.5个月,中位生存期为8.6个月及8.8个月,1年生存率为17.2%及18.1%,2年生存率为8%及10%.两组间比较差异无统计学意义(P＞0.05).GP组不良反应以血小板降低为主,TP组以白细胞减少为主,两组间比较差异无统计学意义(P＞0.05),TP组过敏、脱发和外周神经毒性稍高,差异有统计学意义,反应均可耐受.结论 TP及GP方案治疗晚期非小细胞肺癌具有较好的耐受性和临床疗效,二者疗效和生存率比较差异尤统计学意义.

Clinical efficacy and adverse effects of taxel plus carboplatin or gemcitabine plus carboplatin in patients with advanced non-small-cell lung carcinoma

Objective To observe the clinical efficacy and adverse effects of taxel plus carboplatin (TP) or gemcitabine plus carboplatin (GP) in patients with advanced non-small-cell lung carcinoma. Methods A total of 86 patients with advanced non-small-cell lung carcinoma with a histologically confirmed diagnosis at our department were treated with at least two cycles of drug therapy according to the WHO standard. There were 43 cases in TP group and 43 cases in GP group. TP group: taxel 150 mg/m2, d1, carboplatin 300 mg/m2 in d1; GP group:gemcitabine 1000 mg/m2, 30 min, d1, 8, carboplatin 300 mg/m2 in d1, 3 weeks a cycle. The efficacy and side effects were analyzed after two cycles of chemotherapy. Results When TP and GP groups were compared, the effective rate was 44. 2% vs 39. 5%; disease control rate (CR + PR +SD): 81.4% vs 74. 4%; median time to progress (TTP): 4. 6 vs 4. 5 months; medium survivals: 8.6 vs 8. 8 months; 1-year survival rates: 17. 2% vs 18. 1%; 2-year survival rates: 8% vs 10%. The statistic analysis showed that the two groups had no significant difference. The main cytotoxicities of GP and TP groups were predominantly thrombocytopenia and leucopenia respectively. The two groups had no significant statistical difference. The incidences of allergen, alopecia and peripheral neurotoxicity were higher in the TP group. The two groups had statistical difference. Tolerance was excellent in both groups. Conclusion The therapeutic effect and tolerance are excellent for advanced non-small cell lung carcinoma. The efficacy and survival rate of two groups show no statistical difference.