紫杉醇脂质体和吉西他滨分别联合顺铂治疗晚期非小细胞肺癌的效果及其与中性粒细胞/淋巴细胞比值的相关性  

Curative effect of liposomal paclitaxel and gemcitabine combined with cisplatin on advanced non small cell lung cancer

作　　者：周红兵[1] 艾伟[1] 孙林[1] 夏敏[1] 

机构地区：[1]四川省崇州市人民医院呼吸内科,611230

出　　处：《中国医药》2015年第4期468-472,共5页China Medicine

摘　　要：目的 探讨紫杉醇脂质体和吉西他滨分别联合顺铂治疗晚期非小细胞肺癌（NSCLC）的疗效及其与中性粒细胞/淋巴细胞比值（NLR）的相关性.方法 选取2006年3月至2012年5月四川省崇州市人民医院呼吸内科收治的126例NSCLC患者,按照随机数字表法分为紫杉醇组和吉西他滨组,每组63例.紫杉醇组给予紫杉醇脂质体联合顺铂治疗;吉西他滨组给予吉西他滨联合顺铂治疗,比较2组患者的近远期疗效、不良反应发生情况.结果 紫杉醇组患者治疗总体有效率明显低于吉西他滨组[65.1％ （41/63）比84.1％ （53/63）,P＜0.05];但2组患者的疾病控制率差异无统计学意义[87.3％（55/63）比92.1％（58/63）,P＞0.05].吉西他滨组不良反应发生率明显高于紫杉醇组[55.6％ （35/63）比27.0％（17/63）,P＜0.05].2组间稳定提高率差异无统计学意义[84.1％ （53/63）比90.5％ （57/63）,P＞0.05].紫杉醇组高NLR患者的1、2年生存率分别为56.0％ （14/25）和36.0％ （9/25）,低NLR患者分别为92.1％（35/38）和63.2％（24/38）;吉西他滨组高NLR患者的1、2年生存率分别为66.7％（18/27）和40.7％ （11/27）,低NLR患者分别为88.9％ （32/36）和72.2％（26/36）;高NLR患者的1、2年生存率均明显低于低NLR患者,差异均有统计学意义（均P＜0.05）,但紫杉醇组和吉西他滨组高NLR患者1、2年生存率比较差异无统计学意义（均P＞0.05）.结论 相比紫杉醇联合顺铂而言,吉西他滨联合顺铂化疗方案治疗NSCLC近期疗效较好但不良反应发生率高,NLR可作为判断2种化疗方案治疗预后的良好指标.Objective To investigate the effect of liposomal paclitaxel and gemcitabine combined with cisplatin on advanced non small cell lung cancer （NSCLC） and the correlation between prognosis and neutrophil lymphocyte ratio （ NLR）. Methods A total of 126 patients with NSCLC in Chongzhou People＇s Hospital Department of Respiratok, from Mareh 2006 to May 2012 were recruited and randomly divided into liposomal paclitaxel plus cisplatin （ paclitaxel group） and gemcitabine plus cisplatin （ gemcitabine group） , with 63 cases in each group. The clinical short and long term efficacy, adverse reaction and the changes of NLR were compared between the two groups. Results The overall efficacy of paclitaxe] group was significantly lower than that of gemcitabine group [65.1% （41/63） vs 84.1% （53/63） , P 〈0. 051 , while the disease control rate in the two groups showed no significant difference [ 87.3% （55/63） vs 92.1% （58/63） , P 〉 0.05 ]. The adverse reaction incidence of gemcitabine group was significantly higher than that of paclitaxel group [ 55.6% （35/63） vs 27.0% （ 17/ 63 ）, P 〈 0.05 ]. Moreover, the stable increase rate of paclitaxel group was slightly lower than that of gemcitabine group with no significant difference [ 84.1% （53/63） vs 90.5% （57/63） , P 〉 0.05 ]. One and two year survival rate of patients with high NLR was 56.0% （ 14/25 ） and 36.0% （ 9/25 ）, with low NLR was 92.1% （ 35/38 ） and 63.2% （ 24/38 ） in paclitaxel group, with high NLR was 66.7% （ 18/27 ） and 40.7% （ 11/27 ）, with low NLR was 88.9% （32/36） and 72.2% （26/36） in gemcitabine group, respectively, high NLR patients were significantly lower than those of patients with low NLR （ all P 〈 0.05 ）. But no significant differences in 1 and 2 year survival rate between paelitaxel and gemcitabine group were found. Conclusion Compared with paclitaxel combined with eisplatin, the curative effect of gemcitabine combined with cisplatin is better in treatment of NSCLC but wi

关 键 词：非小细胞肺癌 紫杉醇脂质体 吉西他滨 

分 类 号：R734.2[医药卫生—肿瘤]