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目的探讨临床上如何有针对性地选择应用NP方案(长春瑞宾联合顺铂)和GP方案(健择联合顺铂)治疗晚期非小细胞肺癌。方法随机将患者分为NP方案治疗组和GP方案治疗组,对比观察两组的临床疗效及不良反应。结果两组治疗有效率分别为32.0%和38.1%,1年生存率分别为36.0%和38.1%,两组疗效无显著差异(P>0.05);但两组的不良反应有明显不同之处,NP组WBC减少发生的时间和减少的程度明显早于和重于GP组(P0.05),末梢神经炎及肌肉/关节疼痛的发生率NP组也多于GP组。结论对年龄较轻,治疗前WBC偏高,预计患者骨髓造血功能对化疗耐受性较好者选用NP方案,且患者年龄相对较轻,对末梢神经炎及肌肉/关节疼痛的耐受性也较好;与上述情况相反的患者,宜选用GP方案。
Objective To investigate how to selectively use NP regimen (vinorelbine plus cisplatin) and GP regimen (gemcitabine plus cisplatin) in the treatment of advanced non-small cell lung cancer. Methods Patients were randomly divided into a NP regimen and a GP regimen. The clinical efficacy and adverse reactions were compared between the two groups. Results The effective rates of the two groups were 32.0% and 38.1%, respectively, and the one-year survival rates were 36.0% and 38.1%, respectively. There was no significant difference between the two groups (P>0.05). However, there were significant differences in the adverse reactions between the two groups. The reduction of WBC incidence and reduction in the NP group was significantly earlier than that of the GP group (P<0.05). The incidence of peripheral neuritis and muscle/joint pain was also higher in the NP group than in the GP group. Conclusions For younger age and higher WBC before treatment, it is expected that patients with better bone marrow hematopoietic function are more tolerant of chemotherapy and choose NP regimen. The patients are relatively younger and have more tolerance to peripheral neuritis and muscle/joint pain. Good; In contrast to the above, GPs should be used.