吉西他滨联合顺铂与联合多西紫杉醇治疗非小细胞肺癌的随机对照研究  

Control Observation of Toxicity and Clinical Activity by Gemcitabine plus Cisplatin and Gemcitabine plus Decetaxel in Treatment of Advanced Non-Small Cell Lung Cancer

作　　者：王亚兰[1] 于焕欣 艾洁[1] 

机构地区：[1]包头市肿瘤医院肿瘤内科,内蒙古包头014030

出　　处：《肿瘤基础与临床》2008年第2期133-135,共3页journal of basic and clinical oncology

摘　　要：目的含铂类方案目前是治疗晚期非小细胞肺癌(NSCLC)的标准方案,但其严重的毒副反应促使人们寻找新的替代方案,本研究探讨用吉西他滨联合多西紫杉醇与吉西他滨联合顺铂方案治疗晚期NSCLC的疗效、生存率及毒副反应。方法对62例经病理或细胞学证实的晚期NSCLC的初治患者给予联合化疗,随机分为GT(吉西他滨联合多西紫杉醇)组与GP(吉西他滨联合顺铂)组,两组病例具有可比性,GT组31例,吉西他滨1 000 mg/m2,静脉滴注,d1,8,多西紫杉醇(艾素)75 mg/m2加入生理盐水200 mL中静脉滴注1 h,d1;GP组31例,吉西他滨1 000 mg/m2,静脉滴注,d1,8,顺铂25 mg/m2,静脉滴注,d1-3,21 d为1个周期,每例治疗不超过6个周期。结果GT组患者总有效率为35.4%,1年生存率为76.2%,中位生存期18.6个月,中位TTP 4.9个月,中位PFS3.0个月;GP组患者总有效率为32.2%,1年生存率为67.8%,中位生存期为14.6个月,中位4.4个月,中位PFS3.0个月。两组间有效率、1年生存率、中位生存期差异无统计学意义。最常见的毒副反应为恶心呕吐,GT和GP组的Ⅲ+Ⅳ度反应发生率分别为3.2%和54.8%,差异有统计学意义(P<0.05),其余毒副反应轻微,可耐受。结论吉西他滨联合多西紫杉醇与吉西他滨联合顺铂相比疗效相似,但毒副反应轻,安全可行,耐受性好,中位生存期、1年生存率及生活质量以吉西他滨联合多西紫杉醇的非铂方案较好,值得临床推荐应用。Objective To evaluate the toxicity and clinical activity of gemcitabine （GEM） plus cisplatin （DDP） and gemcitabine （GEM） plus decetaxel in the treatment of advanced non-small cell lung cancer （ NSCLC）. Methods 62 advanced non-small cell lung cancer patients without surgical treatment were randomized into two groups with GP （ GEM ＋ DDP） and GT（ GEM ＋ TAX）. Results The response rates of GP and GT group were 32.2% and 35.4% respectively. The one-year survival rates of GP and GT group were 67.8% and 76.2% respectively. The median survival time was 14.6 month and 18.6 month respectively. The two groups of the response rate, one-year survival rate and median survival time no significance （ P 〉 0.05 ）. The main side effects were vomiting and disgusting, toxicities of theⅢ -Ⅳ grade of GT and GP was 3.2% and 54.8% , the two groups of toxicities were significance（P 〈0.05） , the GT group was better than the GP group. Conclusions The curative effect by GP and GT plan treatment for later period non-small cell lung cancer is good, but the toxicity responded of GT more endured, and this plan is worth promoting the application in clinic.

关 键 词：非小细胞肺癌 化疗 多西紫杉醇 吉西他滨 顺铂 

分 类 号：R734.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]