不同顺铂给药方案联合长春瑞滨治疗非小细胞肺癌  

Different dose-schedule regimens of cisplatin plus vinorelbine in the treatment of the patients with non-small cell lung cancer

作　　者：叶瑞萍[1] 陈振东[1] 梁维龙[2] 吴秀伟[1] 张明军[1] 

机构地区：[1]安徽医科大学第一附属医院肿瘤内科,合肥230022 [2]安徽医科大学第一附属医院肾内科实验室,合肥230022

出　　处：《安徽医科大学学报》2009年第2期269-272,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的探讨不同顺铂给药方案联合长春瑞滨治疗晚期非小细胞肺癌的疗效和不良反应。方法143例患者分为顺铂小剂量连续给药组(45例,顺铂15mg/m2,第1～5天)、中剂量连续给药组(44例,顺铂25mg/m2,第1～3天)、大剂量一次给药组(54例,顺铂80mg/m2,第1天);3组均联合长春瑞滨25mg/m2,第1、8天。4周为1周期,2周期后评价患者疗效、不良反应、疲劳状况和化疗前后尿微量蛋白的变化。结果可评价病例129例,小、中、大剂量组的近期有效率分别为31.1%、31.8%、37.5%,疗效差异无显著性(P>0.05)。大剂量组的恶心、呕吐,Ⅲ～Ⅳ级骨髓抑制的发生率均明显高于中、小剂量组。大剂量组患者化疗后疲劳评分较化疗前明显升高;尿白蛋白、免疫球蛋白G、β2微球蛋白水平也较化疗前均明显增高,中、小剂量组仅β2微球蛋白水平较化疗前有所增高。结论小剂量顺铂连续给药联合长春瑞滨治疗非小细胞肺癌疗效肯定,耐受性更好。Objective To investigate the therapeutic effects and side effects of different dose-schedule regimens of cisplatin plus vinorelbine in the standard first-line treatment of advanced non-small cell lung cancer （NSCLC）. Methods A total of 143 NSCLC patients were divided into three groups. In the low dose consecutive administration group,cisplatin was administered on day 1 -5 at 15 mg/m^2;in the middle dose consecutive administration group, cisplatin was administered on day 1 - 3 at 25 mg/m^2 ; and in the high dose group, cisplatin was administered on day 1 at 80 mg/m^2. Each patient received the chemotherapy of cisplatin combined with vinorelbine on days 1 and 8 at 25 mg/m^2 intravenously. Four weeks was defined as one cycle. The therapeutic effects, side effects, the status of fatigue and the changes of proteinuria were evaluated after two cycles of chemotherapy. Results In the evaluable 129 cases, the response rates of the three groups were 31.1% ,31.8% and 37.5% respectively,which had no significant differences （P 〉 0. 05 ）. The incidences of nausea/vomiting and grade Ⅲ- Ⅳ myelosuppression in the high dose group were significantly higher than middle and low dose groups. In the high dose group, the post-chemotherapy fatigue scores were significantly higher than those of pre-chemotherapy and the concentrations of albumin, IgG and β2-MG in urine all increased. While in the middle and low dose groups ,the albumin, IgG in urine remained unchanged, only β2-MG increased. Conclusion The therapeutic effects of the low dose consecutive administration combined with NVB is confirmed and the patients are well tolerated.

关 键 词：顺铂/治疗应用 癌 非小细胞 肺/药物疗法 疲劳 蛋白尿 

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