多西紫杉醇加铂类两周方案治疗晚期非小细胞肺癌的疗效和生活质量评价  

Every-2-week docetaxel plus platinum In advanced non-small cell lung cancer: response rate and quality of life assessment

作　　者：吴海鹰[1] 戴文清[1] 刘俊玲[1] 段海波[1] 黄蕾[1] 史艳侠[1] 

机构地区：[1]中山大学肿瘤防治中心化疗科,广东广州510060

出　　处：《中华肿瘤防治杂志》2006年第17期1325-1328,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：广州市科技局基金(2002J1-C0321)

摘　　要：目的:研究多西紫杉醇加铂类药物2周给药一线治疗晚期非小细胞肺癌(non-smallcelllungcancer,NSCLC)的疗效、毒副反应及生活质量评价。方法:多西紫杉醇75mg/m2静脉滴入,加用卡铂300mg/m2静脉滴入或顺铂25mg/(m2·d)×3d静脉滴入联合化疗,每2周重复疗程。化疗期间用G-CSF预防性支持治疗。采用EORTCQLQ-C30和QLQ-LC13量表评价患者生活质量。化疗前、下个疗程的前1d及化疗结束后给予评价患者生活质量。结果:47例初治的晚期NSCLC接受化疗,42例患者可评价疗效,其中1例(2·4%)CR,16例(38·1%)PR,24例(57·1%)SD,1例(2·4%)PD。总有效率RR为40·5%。多西紫杉醇加顺铂组28例,RR35·7%,SD60·7%,PD3·6%;多西紫杉醇加卡铂组14例,RR50·0%,SD50·0%。两组有效率比较差异无统计学意义,P=0·374。毒副反应主要为骨髓抑制、恶心呕吐、脱发、肌肉关节痛及疲劳等。化疗后患者躯体功能较化疗前提高,咳嗽、气促、咯血及肩痛等症状明显缓解,整体生活质量并未因化疗而下降。客观疗效稳定的患者与有效患者生活质量改善相似。结论:多西紫杉醇加铂类药物每2周给药是治疗晚期NSCLC的有效可行的方案,毒性反应患者可耐受,大部分患者在化疗后可获得明显的症状和生活质量的改善。OBJECTIVE： To evaluate the efficacy, toxicity and quality-of-life （QOL） of docetaxel plus platinum drugs given every- 2-week in chemotherapy for patients with advanced NSCLC. METHODS： Docetaxel at dose of 75 mg/m^2 combined with carboplatin at dose of 300 mg/m^2 or cisplatin at dose of 25 mg/（m^2·d） for 3 days were administered by intravenous infusion. The chemotherapy was repeated every 2 weeks with the prophylactic use of G-CSF. QOL was assessed by EORTC QLQ-C30 and QLQ-LC13 at baseline, one day before next cycle and after the completion of the chemotherapy. RESULTS： A total of 47 chemotherapy naive patients with advanced NSCLC were performed with the chemotherapy, and 42 were assessable. Of the 42 patients, 1（2.4%） achieved CR, 16（38.1%） PR, 24（57.1%） SDand 1（2.4%） PD. The total ＂response rate was 40.5%, with the response rate of docetaxel plus cisplatin being 35.7% and the response rate of docetaxel plus carboplatin being 50.0% （P = 0. 374）. The major toxicity included myelosuppression, nausea and vomiting, alopecia, myalgia and arthralgia, and fatigue. The physical function of the patients was improved after the chemotherapy. Symptoms such as cough, dyspnea, hemoptysis and shoulder pain were relieved after the chemotherapy. Global QOL was not deteriorated after chemotherapy. The improvement of QOL for patients with stable disease was similar to that of responders. CONCLUSIONS： The biweekly combination chemotherapy with docetaxel and platinum is feasible and effective for patients with advanced NSCLC. The toxicity of this regimen is well tolerated by patients. The symptoms and QOL have improved significantly after the chemotherapy.

关 键 词：癌 非小细胞肺/药物疗法 紫杉酚/治疗应用 顺铂/治疗应用 卡铂/治疗应用 药物疗法 联合 生活质量 

分 类 号：R734.2[医药卫生—肿瘤]