论文部分内容阅读
背景与目的:晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)预后差,以铂类为基础的两药联合化疗虽可延长生存期,但如何选择化疗方案值得探讨。本研究旨在对比3种顺铂联合化疗方案(NP、TP、GP)初始治疗晚期NSCLC的有效率和生存时间。方法:晚期NSCLC患者192例,随机分为3组。NP组(64例):长春瑞滨25 mg/m2,第1、8天,顺铂75 mg/m2,第2天;TP组(63例):紫杉醇175 mg/m2,第1天,顺铂75 mg/m2,第1天;GP组(65例):吉西他滨1 250 mg/m2,第1、8天,顺铂75 mg/m2,第1天;21～28 d为1个周期,至少化疗2个周期后评估有效率和药物不良反应,对比生存时间。结果:GP、TP和NP组的总有效率分别为29.69%、33.33%和32.30%,中位生存时间分别为9.8、9.9和9.5个月,1年生存率分别为40%、38%和37%,差异均无统计学意义(P>0.05)。白细胞减少症发生率NP组每周期45%明显高于TP组每周期32%和GP组每周期18%(P<0.001),血小板减少症发生率GP组16%明显高于NP组1%和TP组2%(P<0.001),脱发和周围神经毒性发生率TP组较高,恶心、呕吐的发生率NP组较高(P<0.05)。结论:尽管不同化疗方案的不良反应不同,但是各组之间疗效终点差异无统计学意义(P>0.05),3种顺铂联合化疗方案治疗晚期NSCLC已处于平台期,化疗方案应当个体化。
BACKGROUND & OBJECTIVE: The prognosis of advanced non-small cell lung cancer (NSCLC) is poor. Although platinum-based combination chemotherapy may prolong survival, it is worth discussing how to choose a chemotherapy regimen. The aim of this study was to compare the efficacy and survival of three cisplatin-based chemotherapy regimens (NP, TP, GP) for the initial treatment of advanced NSCLC. Methods: 192 patients with advanced NSCLC were randomly divided into 3 groups. NP group (64 cases): vinorelbine 25 mg / m2, day 1, day 8, cisplatin 75 mg / m2 on day 2; group TP (63 cases): paclitaxel 175 mg / m2 on day 1 Platinum 75 mg / m2 on day 1; GP group (65 cases): gemcitabine 1 250 mg / m2 on days 1 and 8 and cisplatin 75 mg / m2 on day 1; 21-28 days for 1 cycle, At least 2 weeks after chemotherapy to assess the efficiency and adverse drug reactions, compared to the survival time. Results: The total effective rates of GP, TP and NP groups were 29.69%, 33.33% and 32.30%, respectively. The median survival time was 9.8, 9.9 and 9.5 months respectively. The 1-year survival rates were 40%, 38% and 37% %, The difference was not statistically significant (P> 0.05). The incidence of leukopenia in NP group was significantly higher than that in NP group (45% vs 32%) in TP group and 18% (P <0.001) in GP group. The incidence of thrombocytopenia in GP group was significantly higher than that in NP group The incidence of alopecia and peripheral neurotoxicity in TP group was higher than that in TP group (P <0.001). The incidence of nausea and vomiting was higher in NP group (P <0.05). CONCLUSION: Although the adverse reactions of different chemotherapy regimens are different, there is no significant difference in the end points of efficacy between the two groups (P> 0.05). The three cisplatin combined chemotherapy regimens are in a plateau stage, and chemotherapy regimens should be individualized.