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第三军医大学新桥医院全军肿瘤研究所
纸质出版日期:2009,
网络出版日期:2009-04-30,
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张明慧, 胡义德, 仲晨. 含顺铂的4组联合化疗方案治疗晚期非小细胞肺癌的临床疗效比较[J]. 陆军军医大学学报, 2009,31(8):744-747.
ZHANG MING-HUI, HU YI-DE, ZHONG CHEN. Therapeutic effects of 4 cisplatin-based regimens for advanced non-small cell lung cancer: report of 166 cases. [J]. Journal of army medical university, 2009, 31(8): 744-747.
张明慧, 胡义德, 仲晨. 含顺铂的4组联合化疗方案治疗晚期非小细胞肺癌的临床疗效比较[J]. 陆军军医大学学报, 2009,31(8):744-747. DOI:
ZHANG MING-HUI, HU YI-DE, ZHONG CHEN. Therapeutic effects of 4 cisplatin-based regimens for advanced non-small cell lung cancer: report of 166 cases. [J]. Journal of army medical university, 2009, 31(8): 744-747. DOI:
目的 通过回顾性比较顺铂的4组化疗方案治疗不同组织学类型晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者的疗效差别,以期更好地选择化疗目标人群。 方法 166例NSCLC患者,按组织学类型(鳞癌组94例、腺癌组72例)分别采用TP、GP、NP、DP 4种化疗方案治疗。化疗至少2周期后评价疗效及不良反应。 结果 总有效率(overall response rate
ORR)为34.9%,鳞癌组与腺癌组ORR分别为38.3%、30.6%。其中,不同化疗方案TP、GP、NP、DP比较,鳞癌组的ORR分别是41.7%、44.0%、34.8%、31.8%;中位生存时间(median survival time
MST)分别为:12.1、12.3、11.7、11.8个月; 中位疾病进展时间(time to progression
TTP)分别为:4.4、4.5、3.1、4.4个月;1年生存率分别为:41.7%、44.0%、34.8%、36.4%;腺癌组的ORR分别为27.8%、25.0%、40.0%、28.6%; MST分别为:11.2、11.1、11.5、10.4个月; TTP分别为:3.7、3.2、4.0、4.7个月;1年生存率分别为:33.3%、30.0%、35.0%、35.7%;鳞癌、腺癌组内、组间比较无显著性差异(
P
>0.05)。主要不良反应是骨髓抑制、恶心、呕吐、静脉炎、脱发。GP组血小板减少发生率(51.1%)最高,且Ⅲ°、Ⅳ°血小板减少达24.4%,与其他组比较具有显著差异(
P
<
0.05)。NP组静脉炎的发生率(37.2%)明显高于其他组(
P
<
0.05)。NP组恶心、呕吐发生率(32.9%)较其他组高(
P
<
0.05)。 结论 TP、GP、NP、DP 4种化疗方案治疗不同组织学类型NSCLC疗效相似,不良反应存在差异,应根据患者个体情况进行选择。
Objective To investigate the efficacy of 4 cisplatin-based regimens for advanced non-small cell lung cancer (NSCLC) with different kinds of histology in order to
choose an optimal regimen for the patients. Methods Cisplatin (totally 75 mg/m
i.v. from day 1 to 3) combined with paclitaxel (PTX)
docetaxel (DTX)
gemcitabine (GEM) or vinorelbine (NVB) constituted the regimen of TP
GP
NP and DP. A total of 166 NSCLC patients
including 94 pathologically diagnosed squamous carcinoma and 72 adenocarcinoma were assigned to these 4 regimens respectively. Efficacies and adverse effects were analyzed and compared after 2 cycles of the chemotherapy. Results Overall response rate (ORR) were 34.9%
and squamous carcinoma group and adenocarcinoma group had the ORR of 38.3% and 30.6% respectively. In different regimen groups
ORR of squamous carcinoma were 41.7%
44.0%
34.8%
31.8% for TP
GP
NP and DP regimens respectively
their median survival times (MST) were:12.1
12.3
11.7 and 11.8 months respectively
time to progression (TTP) were:4.4
4.5
3.1 and 4.4 months and 1-year survival rate were 45.0%
44.0%
34.9% and 36.4% respectively. While for adenocarcinoma group
the ORR were 27.8%
25.0%
40.0% and 28.6%
MST were 11.2
11.1
11.5 and 10.4 months
TTP were 3.7
3.2
4.0 and 4.7 months
and 1-year survival rate were 33.3%
30.0%
35.0% and 35.7%. There was no significant differences in MST
TTP and 1-year survival rate between the 2 histological group (
P
>0.05). The major adverse effects were myelo-suppression
nausea
vomiting
phlebitis and alopecie. There were highest incidence of thrombocytopenia (51.1%) in GP regimen group compared with other groups
especially in the stage of Ⅲ° and Ⅳ°(totally accounting for 24.4%) (
P
<
0.05). There were more phlebitis in NP regimen group (
P
<
0.05). The incidence of nausea and vomiting in NP regimen group (37.2%) was significant higher than others (
P
<
0.05). Conclusion There is no significant different in the efficacy of our 4 cisplatin-based regimens for NSCLC with different kinds of histology. However
the incidence of adverse reactions are different
so the selection
of chemotherapeutic agents should be based on individual conditions of patients.
非小细胞肺癌紫杉醇吉西他滨顺铂药物治疗
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