奈达铂联合多西他赛二线治疗晚期非小细胞肺癌的临床观察

目的对比观察奈达铂（NDP）联合多西他赛（TXT）及多西他赛单药二线治疗晚期非小细胞肺癌（NSCLC）的疗效、安全性及生存期。方法人组病例为一线化疗失败的晚期NSCLC患者。联合组：奈达铂80mg／m^2加入等渗盐水500mL中静滴2h，第2天；多西他赛75mg／m^2静滴，第1天，每21天为1周期。单药组：多西他赛75mg／m^2静滴，第1天，每21天为1周期。每例至少接受2个周期化疗后评价疗效，患者最多接受6个周期化疗。结果联合组28例中CR0例，PR7例，总有效率25．0％，疾病控制率71．4％；单药组23例中CR0例，PR4例，总有效率13．0％，疾病控制率60．9％。中位疾病进展时间联合组5．2个月，单药组4．4个月，无显著差异。联合组白细胞下降24例，占85．7％，其中Ⅲ／Ⅳ度占28．5％，血红蛋白和血小板下降分别占21．4％和42．8％，有2例Ⅲ度血小板下降。单药组白细胞下降11例，占47．8％，其中Ⅲ／Ⅳ度占4．35％，血红蛋白和血小板下降分别占17．4％和13．0％，均为Ⅰ度下降。两组比较血液学毒性差异有显著性。结论奈达铂联合多西他赛二线治疗晚期NSCLC有较好疗效，毒副反应可防可控，可供临床安全使用。

Clinical observation of nedaplatin plus docetaxel for second-line treatment in advanced NSCLC

Objective To contrast the curative effect, safety and life span of treatment for second-line nonsmall cell lung cancer with combination of Nedaplantin and Docetaxel to Docetaxel only. Methods The samples are the advanced non-small cell lung cancer patients who failed first-line chemotherapy. The combination group ： the first day, Nedaplantin of 80 mg/m^2 was diluted with 500 mL saline water, iv. for 2 hours. The second day, Docetaxel was given at 75 mg/m^2, iv. The time of each cycle was 21 days. Single-drug group： Docetaxel was given at 75 mg/m^2 , iv. in the first day. The time of each cycle was 21 days. Every patient was treated through chemotherapy treatment for 2 cycles at least and 6 cycles at most. Results The response of 28 cases of combination group in overall was 25.0% and disease control rate was 71.4% , CR： 0, PR： 7 cases. The overall response rate in 23 cases of single-drug group was 13.0% and disease control rate was 60.9% , CR： 0, PR： 4 cases. The median time to progress was 5.2 months for combination group and 4.4 months for single-drug group. There was no significant difference between two groups. In combination group, the rate of neutropenia was 85.7% in 24 cases. And the rate of Ⅲ/Ⅳ was 28.5% , the decrease of platelet and hematin were 21.4% and 42.8% respectively, 2 cases of platelet decrease at Ⅲ degree. In single-drug group, the rate of neutropenia was 47.8% in 11 cases. And the rate of Ⅲ/Ⅳ was 4.35% , the decrease of platelet and hematin were 17.4% and 13.0% respectively, the platelet decrease of all atIdegree. Remarkable differences were shown in the toxicity of hematology between the two groups. Conclusions A good curative effect and controlled toxic reactions were shown in the use of Nedaplantin and Docetaxel in second-line advanced non-small cell lung cancer.