大剂量三苯氧胺提高非小细胞肺癌疗效的研究  

Study of High Dose Oral Tamoxifen Using a Potential Multidrug- Resistance- Reversal Agent in Refractory Patients with Non- Small Cell Lung Cancer

作　　者：蒋芹 张为民 詹茂程 吉亚君 徐光辉 卞宝祥 

机构地区：[1]江苏连云港市第一医院肿瘤科,江苏连云港222002

出　　处：《癌症》2001年第4期426-426,共1页Chinese Journal of Cancer

摘　　要：目的：研究大剂量三苯氧胺 (Tamoxifen,TAM)提高非小细胞肺癌化疗效果。方法：将 108例患者按信封法随机分入 A、 B、 C、 D组，每组 27例患者， A、 B、 C三组为研究组， D组为对照组。研究组化疗前 3天至化疗最后 1天口服 TAM，共 11天。 TAM剂量 A组为 40 mg，每日 3次； B组为 60 mg，每日 3次； C组 80 mg，每日 3次； D组单纯化疗。每组化疗用药相同，均为长春碱酰胺 2.5 mg/m2 d1、 d8，阿霉素 30 mg/m2 d2，顺铂 80 mg/m2分 d4、 d5 2天。每组完成 3周期化疗后休息 30天，复查并评价疗效。结果： A、 B、 C、 D各组有效率分别为： 33.3％ (9/27)、 48.1％ (13/27)、 55.6％ (15/27)、 25.9％ (7/27)， C组有效率最高， D组有效率最低。将 A、 B、 C三组分别与 D组比较，经统计学处理， A∶ D P >0.05； B∶ D P >0.05； C∶ D P< 0.05，有临床意义。各组化疗副作用无区别，仅 C组中有 4例患者用药 5～ 6天后出现精神症状，停服 TAM 1～ 3天后自动恢复正常。结论：大剂量 TAM有拮抗癌细胞对化疗耐药的作用，其剂量与疗效成正相关。Objective: This study was designed to investigate the chemotherapy effect of high- dose tamoxifen(TAM) in the patients with multidrug- resistant (MDR- 1) non- small cell lung cancer(NSCLC). Methods: A total of 108 patients with refractory NSCLC were divided at random into four groups: A,B,C,and D. Each group contained 27 patients. A,B,and C were study group, D was control group. TAM was given from the third day before chemotherapy up to 11 days dose of TAM for group A: 40 mg, tid;group B: 60 mg, tid;group C: 80 mg, tid;group D: Simple chemotherapy. The dosage and schedule of the chemotherapy regimen was just same in every group: VDS 2.5 mg/m2 d1,d8, ADM 30 mg/m2 d2, DDP 80 mg/m2 d4,d5. The therapeutic effect of each group after having been performed 3 cyeles,and treatment rested 30 days was evaluated. Results:The response rates of the A,B,C,and D group were 33.3％ (9/27),48.1％ (13/27),55.6％ (15/27),25.9％ (7/27),respectively. The response rate of group C was the highest and group D was the lowest. Compared group A,B,C with group D,A∶ D P >0.05, the difference did not reach statistical significance; B∶ D P >0.05, the difference did not reach statistical significance; C∶ D P< 0.05,the difference reached statistical significance. The major side effect of chemotherapy had not difference in every group. Only four patients of group C with TAM 240 mg/d developed psychiatric symptom, and TAM was abandoned after symptom automatic extinction. Conclusions: High dose TAM can be safely administered and may inhibit MDR- 1 function. The dose of TAM become positive correlation to it s effect.

关 键 词：难治性非小细胞肺癌 多药耐药 三苯氧胺 药物治疗 

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