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目的比较晚期非小细胞肺癌(NSCLC)先给予两种多西他赛联合顺铂的治疗方案后分别再连续性给予吉西他滨进行治疗的效果及其不良反应的差别。方法 84例NSCLC患者(ⅢB/Ⅳ),随机分为两组,A组(n=43)为:第1天给予多西他赛75 mg/m2和75 mg/m2顺铂,3周为一个疗程,重复3个周期;3个治疗周期结束后的第1,8天再给予吉西他滨1000 mg/m2静脉滴注,3周为一个治疗周期,重复3个周期。B组(n=41)为:第1,8,15天给予多西他赛25 mg/m2和顺铂25 mg/m2静滴,4周为一个周期,重复3个周期;3个治疗周期结束的第1,8天给予吉西他滨1000 mg/m2静脉滴注,3周为一个治疗周期,重复3个周期。结果 A组的最终病例为43例,B组为40例。两组患者完全缓解(CR)均为0例,A组方案中PR 22例,SD 12例,有效率为51.2%,B组中PR 20例,SD 15例,有效率为50%。两组中性粒细胞Ⅲ/Ⅳ度减少分别是A组为55.1%和B组12.5%,B组不良反应率明显低于A组。结论多西他赛联合顺铂治疗NSCLC后再给予吉西他滨单药的连续性化疗方案疗效显著,多西他赛联合顺铂3周治疗后续用吉西他滨的治疗方案与每周方案疗效相似,但每周方案治疗的毒性反应明显低于三周治疗方案。
Objective To compare the efficacy and adverse effects of gemcitabine once again given two docetaxel plus cisplatin regimens in patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 84 NSCLC patients (ⅢB / Ⅳ) were randomly divided into two groups. Group A (n = 43) received docetaxel 75 mg / m2 and 75 mg / m2 cisplatin on the first day, The course of treatment was repeated for 3 cycles. Gemcitabine was given intravenously at 1000 mg / m2 on days 1 and 8 of the 3 treatment cycles, one cycle for 3 weeks and 3 cycles for each cycle. In group B (n = 41), docetaxel 25 mg / m2 and cisplatin 25 mg / m2 were intravenously administered on days 1, 8, and 4 for one cycle with three cycles of repetition; three cycles of treatment Gemcitabine 1000 mg / m2 was given intravenously on days 1 and 8 of the end, one cycle for three weeks, and three cycles for cycle. Results The final case in group A was 43 and in group B 40. There were 0 cases of complete remission (CR) and 22 cases of PR and 12 cases of SD in group A. The effective rate was 51.2% in group A, 20 cases in group B and 15 cases in SD. The effective rate was 50%. The neutrophil III / IV reduction in both groups was 55.1% in group A and 12.5% in group B, respectively. The adverse reaction rate in group B was significantly lower than that in group A. Conclusion Continuous chemotherapy with docetaxel plus cisplatin followed by gemcitabine monotherapy resulted in a significant effect. Docetaxel combined with cisplatin followed 3 weeks after gemcitabine was similar to the weekly regimen, but weekly The toxicity of the regimen was significantly lower than that of the three-week regimen.