Objective      To determine the efficiency of gemcitabine combined with nedaplatin chemotherapy or paclitaxel combined with nedaplatin chemotherapy regimen in treatment of advanced non-small cell lung cancer and their toxic reaction.       Methods      A total

of 133 patients with histopathological diagnosis of non-small cell lung cancer

and TNM staging of advanced who hospitalized in our hospital during January 2010 to September 2011 were prospectively enrolled

and then randomly

divided into 2 matched groups

gemcitabine group (n=67) and paclitaxel group (n=66). The patients from the former group were treated with a regimen of gemcitabine (Gem) 1 000 mg/m

2

D1

D8+nedaplatin (NDP) 80 mg/m

2

D1 (or D8) scheme. While

those of the later group received a treatment of paclitaxel (PTX) 175 mg/m

2

D1+80mg/m

2

D1 nedaplatin regimen

for a period of 21 d. In the end of second cycle

the change of target tumor mass was finally evaluated. For the mass without change or increased in size

second-line chemotherapy was carried out. For the target mass was decreased in size

former chemotherapy was continued. The final efficiency of the 2 regimens was assessed in the the end of fourth cycle

and their toxicity reactions were compared.        Results      There were 55 patients of gemcitabine group who completed 4 cycles of chemotherapy

and 30 of them achieved complete (CR) or partial remission (PR)

including 27 cases of squamous cell carcinoma. The treatment efficiency was 54.55%. Fifty-one patients of paclitaxel group completed the 4 cycles

with 26 cases achieving CR or PR

including 26 cases of adenocarcinoma

with a efficiency of 50.98%. Hematologic toxicity of gemcitabine chemotherapy displayed the leukocytes was decreased at different degrees

mainly Ⅰ to Ⅱ. But no significant difference was found in the white blood cells and platelets for the patients with Ⅲ and Ⅳ bone marrow depression patients between the 2 groups (P0.05). But hemoglobin was decreased

with gemcitabine group significantly higher than paclitaxel group (P0.05). There were more constipation found in the gemcitabine group than paclitaxel group (P0.05)

but more hair loss

peripheral nerve damage

and myalgia in paclitaxel group than gemcitabine group (P0.05). No di

fference was observed in other symptoms between the 2 groups (P0.05). Also no chemotherapy related death was seen in the 2 groups.       Conclusion      There is no significant difference in short-term efficiency of the 2 chemotherapy regimens. Gemcitabine may be suitable to squamous cell carcinoma

while paclitaxel to non squamous cell carcinoma. Toxic reactions are tolerant to the patients of 2 groups. Gemcitabine groups have less subjective symptoms

so have better  tolerance and compliance.