紫杉醇持续输注联合顺铂治疗晚期非小细胞肺癌

背景与目的：在许多国家肺癌的发病率和死亡率急剧增长，治疗肺癌的药物和方法不断涌现。本研究探讨紫杉醇静脉持续注射联合顺铂治疗晚期非小细胞肺癌的疗效和毒性。方法：61例晚期非小细胞肺癌患者被随机分为两组，治疗组（31例）方案：紫杉醇按总量150mg／m^2 48h静脉持续输注，第1～2天；顺铂按总量75mg／m^2分3d静点，即第3、4、5天。对照组（30例）方案：紫杉醇按总量150mg／m^2分2次静点，即第1、8天，每次持续3h，顺铂用法同治疗组。所有患者每周期21d，每个患者治疗3个周期以上。结果：治疗组与对照组的近期有效率分别为54．84％（17／31）、43．33％（13／30），中位治疗进展时间7．1个月、5．8个月，中位生存时间（MST）14．0个月、10．2个月，1年生存率67．74％（21／31）、33．33％（10／30），2年生存率22．58（7／31）％、13．33％（4／30），其中1年生存率治疗组显著高于对照组（P〈0．05），其余差异均无显著性（P〉0．05）。两组患者的不良反应有：骨髓抑制、恶心呕吐、脱发、外周神经毒性、肝功异常、肾功异常、静脉炎，两组发生率相当。结论：较传统用法，紫杉醇持续输注治疗晚期非小细胞肺癌能够提高有效率，显著改善生存情况。毒副反应无明显增加。

Continuous infusion of paclitaxel combined with cisplatin in the treatment of advanced non-small-cell lung cancer

Background and purpose:The incidence and mortality of lung cancer are markedly increasing all over the world, new drug and new methods in the treatment of lung cancer has been continuously explored and reported. Our study was to evaluate the efficacy and toxicity of continuous infusion of paclitaxel combined with cisplatin in the treatment of advanced non-small-cell lung cancer. Methods:61 patients were randomized into two groups, in the study group (31cases), the patients were treated with continuously infused paclitaxel for 48 hour at day1-2 with total dose 150 mg/m 2 , and cisplatin at day3,4,5 by intravenous injection with total dose 75 mg/m 2 . The patients in the control group(30 cases) received paclitaxel by intravenous injection for at least 3 hours at day 1, 8 with 150 mg/m 2 , and the same dose and administration of cisplatin as study group. More than three cycles were deliveried with three weeks apart to each cycle.Results:The objective response rates(RR) in the study group and control group were 54.84%(17/31)vs 43.33%(13/30),respectively; time to progress (TTP) were 7.1 months in the study group vs 5.8 months in the control group; median survival time (MST) were 14.0 months vs 10.2 months; 1-year survival rates were 67.74%(21/31)vs 33.33%(10/30)(P< 0.05 ) and 2-year survival rate 22.58%(7/31)vs 13.33%(4/30)(P>0.05). The toxicities that occurred in the two group included bone marrow suppression,nausea/vomiting, alopecia, peripheral neurotoxicity,impaired liver function,impaired renal function and phlebitis. There was no significant difference between the two groups in terms of the incidence of toxicites.Conclusions:In the treantment of advanced NSCLC , compared to conventional administration in delivery of the drugs, continuous infusion of paclitaxel can increase response rate and significantly improve 1-year survival fraction without the increase of toxicities.