吉西他滨联合顺铂方案在非小细胞肺癌术后辅助化疗中的疗效及影响因素分析

目的: 观察术后接受吉西他滨联合顺铂(GP)方案辅助化疗的非小细胞肺癌（NSCL
C）患者的近期疗效，探讨影响疗效的因素并分析其不良反应。方法: 回顾性分析68例NSCLC术后且行GP方案辅助
化疗患者的临床资料。采用Kaplan-Meier法绘制无病生存曲线，不同亚组间用Log-rank时
序检验；单因素、多因素分析采用COX比例风险回归模型。结果: 本组患者整体中位无复发生
存时间为33.7个月，随访1年以上的患者56例，1年无病生存率为83.9%，随访2年以上
的患者25例，2年无病生存率为72.0%。单因素分析，临床分期(P<0.05)、病理类型(P<
0.05)、分化程度(P<0.05)是影响近期疗效的因素；多因素分析，临床分期(P<0.05)、分化程
度(P<0.05)是影响近期疗效的独立因素。主要的不良反应为Ⅲ-Ⅳ度骨髓抑制［包括粒细胞减少（
33.9%），白细胞减少（20.6%），贫血（4.4%），血小板减少（4.4%）］和Ⅲ-Ⅳ度恶心及呕
吐(10.3%)。结论：GP方案在NSCLC患者术后辅助化疗中的1、2年疾病控制率高，不良反应
轻；其中临床分期及分化程度是NSCLC患者术后接受GP方案辅助化疗近期疗效的影响因素。

Efficacy and influencing factor analysis of GP regimen in postoperative adjuvant chemotherapy for non-small-cell lung cancer

Objective To observe the short-term efficacy of GP regimen in adjuvant chemotherapy in patients with non-small-cell lung cancer,and to study the factors influencing efficacy and analyze the adverse reactions.Methods Clinical data of 68 NSCLC patients received postoperative adjuvant chemotherapy of GP regimen was retrospectively analyzed.Kaplan-Meier method was used to draw the disease-free survival curve.Log-rank time series analysis was used between different subgroups;COX proportional hazards model was used for the univariate and multivariate analyses.Results Of all the 68 cases,the median recurrence-free survival time was 33.7 months,56 cases were followed up more than one year,and one year disease-free survival rate was 83.9%;25 cases were followed up more than two years,and two-year disease-free survival was 72.0%.Univariate analysis suggested that clinical stage(P<0.05),pathological type(P<0.05),degree of differentiation(P<0.05) significantly influenced the short-term efficacy.Multivariate analysis suggested that clinical stage(P<0.05),degree of differentiation(P<0.05) were the independent factors of the short-term efficacy.The major adverse reactions were stage 3 to 4 myelo-suppression including neutropenia(33.9%),granulocytopenia(20.6%),anemia(4.4%),and thrombocytopenia(4.4%),and stage 3 to 4 nausea and vomiting(10.3%).Conclusion The GP regimen is feasible,well-tolerated with a high disease control rate in one or two years in the adjuvant chemotherapy;clinical stage and degree of differentiation are the independent factors of the short-term efficacy.