紫杉醇脂质体对比吉西他滨联合顺铂一线治疗中晚期肺鳞癌的疗效评价  

Effectiveness and safety of paclitaxel liposome in combination with cisplatin as first-line chemotherapy for advanced squamous lung cancer

作　　者：杨静翔 罗虎[1] 周向东[1] 

机构地区：[1]第三军医大学西南医院呼吸内科,重庆400038

出　　处：《第三军医大学学报》2014年第2期140-143,共4页Journal of Third Military Medical University

摘　　要：目的对比紫杉醇脂质体联合顺铂方案(LP)与吉西他滨联合顺铂方案(GP)一线治疗Ⅲ/Ⅳ期肺鳞癌的临床疗效、毒副作用及远期预后。方法共纳入71例Ⅲ/Ⅳ期鳞癌患者,LP组37例,GP组34例,分别给予注射用紫杉醇脂质体(175 mg/m2)+顺铂(75 mg/m2)和注射用吉西他滨(1 000 mg/m2)+顺铂(75 mg/m2)治疗,21 d为1个周期;2个周期化疗结束后系统评价其疗效。结果对于肺原发灶2组客观缓解率(37.8%vs 32.4%,P=0.629)和疾病控制率(83.8%vs 76.5%,P=0.439)差异无统计学意义;对于区域转移的淋巴结2组客观缓解率(45.9%vs 20.6%,P=0.024)和疾病控制率(86.5%vs 64.7%,P=0.032)均为LP组显著增高。LP组无进展生存期高于GP组(7.0个月vs 5.0个月,P=0.014)。LP化疗组血小板减少、恶心及呕吐发生率低于GP化疗组(P<0.05)。结论对于伴有区域淋巴结转移的鳞癌患者,LP方案毒副作用更少,可获得更高的无疾病进展生存期,可能更能使患者获益。Objective To compare the effectiveness and safety of paclitaxel liposome plus cisplatin （LP） with gemcitabine plus cisplatin （GP） in advanced lung squamous cell carcinoma （SCC） with regional lymph node metastasis. Methods Seventy-one advanced lung SCC patients were assigned to receive either paclitaxel liposome （ 175 mg/m2 ） plus cisplatin （ 75 mg/m2 ） （ LP group, n = 37 ） or gemcitabine （ 1 000 mg/m2 ） plus cisplatin （75 mg/m2 ） （ GP group, n = 34） every 3 weeks. All patients were treated with at least two 21-day courses, and evaluated by chest CT every two courses. Results No statistical difference was observed between the LP and GP groups in terms of objective response rate （ORR） of lung primary foci （37.8 % vs 32.4%, P = 0. 629） and the disease control rate （DCR） of lung primary foci （83.8% vs 76. 5%, P = O. 439 ）. LP group had higher ORR of regional metastasis lymph node （45.9% vs 20.6%, P = O. 024 ） and DCR of regional metastasis lymph node （86.5% vs 64.7%, P = 0. 032）. Longer progression free survival （PFS） was observed in LP group （7.0 vs 5.0 months, P =0. 014）. LP group was associated with significantly less thrombocytopenia, nausea and emesis（P 〈 0. 05 ）. Conclusion Paclitaxel liposome plus cisplatin seems to be superior to gemcitabine plus cisplatin for lung SCC treatment with less toxicity, better tolerance and longer PFS.

关 键 词：紫杉醇脂质体 吉西他滨 肺肿瘤 化疗 

分 类 号：R734.2[医药卫生—肿瘤] R969.4[医药卫生—临床医学]