TC和MVP治疗晚期非小细胞肺癌前瞻随机研究  

A PROSPECTIVE RANDOMIZED STUDY OF TC AND MVP IN ADVANCED NON-SMALL CELL LUNG CANCER

作　　者：于杰[1] 衣喜梅 张楠[1] 

机构地区：[1]青岛市第三人民医院内科,山东青岛266041 [2]青岛双桃医院

出　　处：《齐鲁医学杂志》2006年第1期43-44,46,共3页Medical Journal of Qilu

摘　　要：目的 评价TC和MVP两种方案治疗晚期非小细胞肺癌（NSCLC）有效率、毒性和生存期。方法 68例晚期NSCLC病人随机分为两组：TC组34例，MVP组34例。TC组给予国产紫杉醇（Paclitaxel）175mg／m^2静滴第1天；卡铂（CBP）300mg／m^2静滴第2天。MVP组给予丝裂霉素（MMC）6～8mg／m^2静滴第1天；长春花碱酰胺（VDS）2～3mg／m^2，静滴第1、8天；顺铂（DDP）70-80mg／m^2，静滴第1、2天。两方案均为每周期21d，每例完成2～4周期。结果TC组有效率为62％（完全缓解1例，部分缓解20例），MVP组有效率为26％（完全缓解1例。部分缓解8例），TC组有效率显著高于MVP组（χ^2=8．589，P〈0．05）。恶心、呕吐及骨髓抑制为主要化疗反应。MVP组Ⅲ、Ⅳ度恶心、呕吐发生率高于TC组，差异有显著性（χ^2=7．503，P〈0．01）。Ⅲ、Ⅳ度骨髓抑制MVP组稍高于TC组，但差异无显著性。TC组与MVP组的中位生存期分别为10个月与8个月，1年生存率为47％与20％（χ^2=5．321，P〈0．05），2年生存率为17％与6％，3年生存率为2％与0。结论 TC组有效率高于MVP组，且恶心、呕吐和骨髓抑制发生率低，该方案是晚期非小细胞肺癌化疗的较佳方案。Objective To evaluate the response, adverse effects and life span of TC and NVP therapeutic regimens for non-small cell lung cancer （NSCLC）. Methods Sixty-eight patients with advanced NSCLC were randomized into two groups; TC group （n= 34, paclitaxel 175 mg/m^2, dl, carboplatin 300 mg/m^2 , d2） and MVP group （n= 34, mitomycin C 6- 8 mg/m^2 ,d1 ; vindesine 2-3 mg/m^2 d1 and d8; cisplatin 70-80 mg/m^2 ,dl and d2 ）. All patients received two to four courses of chemotherapy. Results The overall response was 62% （21/34）in TC group and 26% （9/34） in MVP group. There was one complete response, 20 partial responses in TC group; one complete response, and eight partial response in MVP group. TC regimen appeared to have a higher objective response with statistical difference between two regimens （χ^2 = 8. 589, P〈0.05）. Major side effects were myelosuppression and nausea/vomiting, especially grade Ⅲ, Ⅳ nausea/vomiting were significantly higher in MVP than TC （26% and 3%,χ^2 = 7. 503, P〈0.01）. Grade Ⅲ, Ⅳ myelosuppression was higher in MVP than TC, but with no statistical significance existed in the two groups. Median survival time was 10 months vs eight months, and 1-,2-, 3-year survival rates were 47% vs 20%（χ^2=5. 321, P〈0. 05） ,17% vs 6% ,2% vs 0, for TC and MVP, respectively. Conclusion TC regimen has a higher response rate and longer survival time, less nausea/vomiting and myelosuppression than MVP regimen. TC regimen is a safe and active regimen for advanced non small cell lung cancer.

关 键 词：非小细胞肺癌 药物疗法 方案评价 骨髓抑制 化疗 

分 类 号：R734.2[医药卫生—肿瘤]