HMVP、MVP和HVP方案治疗晚期NSCLC的前瞻性随机研究  

Prospective Randomized Study of HMVP,MVP,and HVP Regimens in Treatment of Advanced Non- Small Cell Lung Cancer

作　　者：高建飞[1] 李长生[2] 章必成[1] 杜光祖[1] 张新华[1] 王军[1] 朱宇泽[1] 欧武陵[1] 杨波[1] 

机构地区：[1]广州军区武汉总医院肿瘤血液科,湖北武汉430070 [2]武汉大学人民医院呼吸内科,湖北武汉430060

出　　处：《癌症》2004年第4期435-438,共4页Chinese Journal of Cancer

摘　　要：背景与目的:非小细胞肺癌(non-smallcelllungcancer,NSCLC)对常用的一、二线化疗方案敏感性较低,在化疗中联用喜树碱类衍生物已引起国内外的研究兴趣。本研究旨在观察羟基喜树碱(hydroxycamptothecin,HCPT)联合丝裂霉素(mitomycin,MMC)、长春花碱酰胺(vindesine,VDS)和顺铂(cisplatin,DDP)组成的HMVP、MVP和HVP方案治疗晚期NSCLC的近期、远期疗效和不良反应。方法:134例晚期NSCLC患者随机分为HMVP组(46例)、MVP组(44例)和HVP组(44例),接受相应方案的化疗,观察各组的近期及远期疗效、不良反应和生存情况。结果:HMVP、MVP和HVP三组的有效率分别为39.54%、36.59%和26.19%,三组之间无显著性差异(P>0.05);三组的中位缓解期、中位生存期、1年及2年生存率亦无明显差别。三组之间的Ⅲ～Ⅳ度白细胞减少、Ⅲ～Ⅳ度血小板减少、Ⅲ～Ⅳ度恶心/呕吐及Ⅲ～Ⅳ度便秘发生率均无显著性差异(P>0.05)。结论:MVP方案治疗晚期NSCLC的疗效略低于HMVP方案,但后者未显示出明显的疗效优势,且可能增加白细胞抑制、恶心/呕吐和便秘的发生率。MVP方案疗效略高于HVP方案。BACKGROUND & OBJECTIVE: Non- small cell lung cancer (NSCLC) i s hyposensitive to the normal first and second- line chemotherapy regimens. Cam ptothecin derivative is becoming a hot point in the treatment of advanced NSCLC. The objective of this article was to evaluate the response, toxicity, and survi val time of HMVP, MVP, and HVP regimens (detail in below) in the treatment of ad vanced NSCLC. METHODS: A total of 134 cases with advanced NSCLC was randomized i nto three groups: HMVP group [46 patients, hydroxycamptothecin (HCPT) 12 mg/m2 f rom d1 to d5, mitomycin C (MMC) 6 mg/m2 d1, vindesine (VDS) 2.5- 3 mg/m2 d1 and d8, cisplatin (DDP) 50 mg/m2 d2 and d3], MVP group (44 patients, MMC, VDS and D DP were the same as HMVP group) and HVP group (44 patients, HCPT, VDS, DDP were the same as HMVP group). RESULTS: The response rates were 39.54% (17/43), 35.5 7% (15/42), and 26.19% (11/42) in HMVP, MVP, and HVP groups, respectively; n o significant difference was detected among the three groups (P >0.05). No signi ficant difference was detected in the median time of remission, median survival time, and 1- , 2- year survival rates among the three groups. Moreover, no sig nificant difference was detected in grade Ⅲ - Ⅳ leukopenia, grade Ⅲ - Ⅳ thrombocytopenia, grade Ⅲ - Ⅳ nausea and vomiting and grade Ⅲ - Ⅳ consti pation among the three groups. CONCLUSION: The response rate of MVP regimen is s lightly lower than that of HMVP regimen, but HMVP regimen do not show obvious su periority. It may increase toxicities such as leukopenia, nausea/vomiting, and c onstipation. The response rate of HVP regimen is slightly lower than that of MVP regimen.

关 键 词：HMVP MVP HVP方案 治疗 晚期NSCLC 非小细胞肺癌 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]