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目的比较健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的疗效和不良反应。方法38例入选病人均为经病理和细胞学证实的晚期非小细胞肺癌,既往未进行化疗和放疗,临床上有可测量病灶(根据WHO标准),ECOG评分为0～2分,肝肾功能基本正常。3周方案组(15例)健择给药时间为第1天和第8天,剂量为1250mgm2,静脉滴注30分钟;顺铂给药时间为第1天,剂量为75mgm2,静脉滴注。4周方案组(21例)健择给药时间为第1天、第8天和、第15天,剂量为1000mgm2,静脉滴注30分钟;顺铂给药时间为第1天,剂量为75mgm2或100mgm2,静脉滴注。结果4周方案组中22例可评价疗效,其中11例PR(50%)、5例SD(22.7%)和6例PD(27.3%);3周方案组中11例可评价疗效,其中5例PR(45.5%)、4例SD(36.4%)和2例PD(18.2%),两组比较无显著差异。4周方案组的中位生存期为8.6个月(2.7～19.1);3周方案组的中位生存期为9.1个月(2.7～11.1),两组无显著差异。主要不良反应是白细胞、中性粒细胞、血小板和血红蛋白减少等血液学毒性,两组间的反应无显著差异。结论健择是有效的抗肿瘤药物,3周方案与4周方案的疗效相似。
Objective To compare the curative effect and adverse reactions of the combination of gemcitabine and cisplatin in the treatment of advanced non-small cell lung cancer for 3 weeks and 4 weeks. Methods Thirty-eight selected patients were all pathologically and cytologically advanced non-small cell lung cancer. Chemotherapy and radiotherapy were not performed in the past. Measurable lesions were found clinically according to the WHO standard. The ECOG score was 0 to 2 and liver and kidney function Basically normal. The 3-week regimen (n = 15) was given gentamicin on day 1 and day 8 at a dose of 1250 mgm2 for 30 minutes; cisplatin was administered on day 1 at a dose of 75 mg m2 intravenously. The 4-week regimen (n = 21) was given gentamicin on day 1, day 8, and day 15 at a dose of 1000 mgm2 for 30 minutes; cisplatin was administered on day 1 at a dose of 75 mg m2 Or 100mgm2, intravenous infusion. RESULTS: Twenty-two patients in the 4-week regimen group were evaluated for efficacy, including 11 PR (50%), 5 SD (22.7%) and 6 PD (27.3% Cases of PR (45.5%), 4 cases of SD (36.4%) and 2 cases of PD (18.2%), no significant difference between the two groups. The median survival for the 4-week regimen was 8.6 months (range, 2.7-19.1). The median survival for the 3-week regimen was 9.1 months (2.7-11.1), with no significant difference between the two groups. The major adverse effects were hematologic toxicity such as diminished white blood cells, neutrophils, platelets and hemoglobin, with no significant differences between the two groups. Conclusion Gemcitabine is an effective anti-tumor drug, and the efficacy of the 3-week and 4-week regimens is similar.