GP方案治疗47例晚期非小细胞肺癌合并矽肺患者的疗效观察  

CLINICAL EFFECT OF GEMCITABINE PLUS CISPLATIN IN 47 CASES OF ADVANCED NONSMALL CELL LUNG CANCER COMBINED WIH SILICOSIS

作　　者：刘素娟[1] 张延可[2] 赵颖[2] 

机构地区：[1]山东省邹城市人民医院肿瘤科,邹城273500 [2]兖矿集团总医院肿瘤中心放疗科

出　　处：《现代预防医学》2009年第9期1776-1777,共2页Modern Preventive Medicine

摘　　要：[目的]评价吉西他滨联合顺铂(GP)方案治疗煤矿工人中晚期非小细胞肺癌(NSCLC)合并矽肺患者的近期疗效和毒副作用。[方法]选择47例经鉴定患有矽肺病史,病理确诊不能手术的晚期(Ⅲ～Ⅳ期)NSCLC患者采用健择联合顺铂化疗,具体为健择1000mg/m2d1、8,静滴30min;顺铂25mg/m2d2、3、4,静滴,21d为1周期,至少完成2个周期后评价疗效,并观察不良反应。[结果]无CR病例,PR18例,SD26例,PD3例,总有效率38.3%,初治患者有效率45.5%,复治患者有效率32%,中位疾病进展时间(MTTP)和中位生存时间(MST)分别为5个月和9.5个月,1年生存率36.2%。主要的不良反应是骨髓抑制,其中Ⅲ～Ⅳ度白细胞及血小板下降率分别为34%和23.4%。[结论]健择联合顺铂治疗晚期NSCLC合并矽肺患者,近期疗效较好,毒副作用可以耐受,其不良反应主要是骨髓抑制,可以在此类患者群中推广应用。[Objective] To evaluate the shortdated therapeutic effects and toxicity reaction of gemcitabine plus cisplatin in the treatment of patients from coal miners who got advanced non-small cell lung cancer （NSCLC） and silicosis. [Methods] 47 patients were identified with silicosis and diagnosed NSCLC by pathology in stage Ⅲ and Ⅳ, which were treated with gemcitabine 1 000 mg / m2 by intravenous infusion on 1st and 8th days, and cisplatin 25mg / m2 by intravenous infusion on 2nd, 3rd, 4th, in a 21 -day cycle. Each patient was treated at least for 2 cycles and then evaluated therapeutic effects and toxicity reaction. [Results] Of the 47 patients, 18 cases got partial response, 26 cases had stable disease, and 3 cases had progressive disease, with an overall response rate of 38.3% . The response rate was 45.5% in the initial patients and 32% in the retreated patients. The median time to progression （MTTP） and medium survivals time （MST） was 5 months and 9.5 months separately. The 1-year survival rate was 36.2%. The main toxicities were leukopenia （incidence of 34% for grade Ⅲ and Ⅳ） and throm-bocytopenia （incidence of 23.4% for grade Ⅲ and Ⅳ）. [Conclusion] Combined chemotherapy of gemcitabine and cisplatin has better shortdated curative efficacy for the NSCLC combined with silicosis. The patients could bear the side effects. The main side effects come from the inhibition on the bone marrow. The scheme is deserved to be utilized widely in this kind of patients.

关 键 词：非小细胞肺癌 矽肺 健择 顺铂 

分 类 号：R734.2[医药卫生—肿瘤] R135.2[医药卫生—临床医学]