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目的:探讨在初治Ⅲb～IV期非小细胞肺癌(NSCLC)中三种治疗方案的优劣。即LM-EP方案犤LIFEIN(力尔凡)、MA(MegestrolAcetate,甲地孕酮)、VP-16与PDD联合的生物化疗方案犦、M-EP方案和EP方案。方法:A组(38例)接受LM-EP方案治疗;B组(38例)接受M-EP方案治疗;C组(36例)接受EP方案治疗。3组均以每4周为一周期,重复3个周期。客观疗效与不良反应按WHO标准进行评价,生活质量根据临床受益疗效评价。结果:A、B、C三组客观疗效(CR+PR)无明显差异性(P>0.05),分别为31.8%、23.7%及22.2%;中位生存期A组较B、C两组长(P均<0.01),分别为35周、29周和27周;临床受益疗效A、B组高于C组(P均<0.05);机体免疫功能A组高于B、C两组(P均<0.01);白细胞减少及恶心呕吐反应C组较A、B两组均显著(P<0.01,P<0.05);短暂性寒战、发热症状多见于A组(P<0.01);两组均未发现其它严重的不良反应。结论:LM-EP方案与M-EP方案和EP方案治疗晚期NSCLC的客观疗效(CR+PR)无明显差异性,但前者不良反应小,中位生存期长,患者免疫功能及生活质量改善明显。
Objective: To investigate the advantages and disadvantages of three treatment regimens in treatment of stage Ⅲb-IV non-small cell lung cancer (NSCLC). Ie LM-EP regimen 犤 LIFEIN, MA (Megestrol Acetate), biochemotherapy program VP-16 and PDD 犦, M-EP regimen and EP regimen. Methods: Group A (38 cases) received LM-EP regimen; group B (38 cases) received M-EP regimen; group C (36 cases) received EP regimen. Three groups were every 4 weeks for a cycle, repeat 3 cycles. Objective and adverse effects according to WHO criteria for evaluation, quality of life based on clinical benefit evaluation. Results: The objective efficacy (CR + PR) of group A, B and C had no significant difference (P> 0.05), which were 31.8%, 23.7% and 22.2% (P <0.01), which were 35 weeks, 29 weeks and 27 weeks respectively. The clinical benefit was higher in group A and B than in group C (all P <0.05). The immune function of group A was higher than group B and C (All P <0.01). The leukopenia and nausea and vomiting responses in group C were significantly higher than those in group A and B (P <0.01, P <0.05) No other serious adverse reactions were found. CONCLUSION: There is no significant difference between the LM-EP regimen and the M-EP regimen and the EP regimen in the treatment of advanced NSCLC. However, the former has a small adverse reaction, a long median survival, and a significant improvement in immune function and quality of life .