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目的观察奈达铂联合紫杉醇(TAX)治疗晚期非小细胞肺癌(NSCLC)的近期疗效、远期生存及毒副反应。方法采用前瞻性随机对照研究方法,以顺铂(DDP)联合TAX为对照,对60例ⅢB和Ⅳ期非小细胞肺癌初治患者进行随机分组。TN组30例,奈达铂30 mg/m2,第1～3天;TAX 175 mg/m2,第1天;每4周重复。TP组27例,DDP 30 mg/m2,第1～3天;TAX 175 mg/m2,第1天;每4周重复。结果TN组与TP组总有效率分别为43.3%和48.1%(P=0.716),疾病控制率分别为86.7%和88.8%(P=0.799)。TN组与TP组患者的中位生存期分别为14.3和13.0个月(P= 0.839),1年生存率分别为62.5%和59.1%,2年生存率分别为0和5.8%。TN组与TP组的中性粒细胞下降和血小板下降相近;TP组比TN组,贫血(38.5%和17.5%,P=0.001)、恶心呕吐(82.6%和35.6%,P=0.000)、乏力反应(35.9%和14.1%,P=0.000)及外周冲经毒性发生率(50.0%和21.9%,P=0.023)更高。结论奈达铂联合TAX是治疗NSCLC的有效方案,可取得与顺铂联合TAX相似的有效率和生存,在某些毒副反应方面显示出一定优势。
Objective To observe the short-term curative effect, long-term survival and side effects of Nedaplatin and paclitaxel (TAX) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods A prospective randomized controlled study was conducted in 60 newly diagnosed non-small cell lung cancer patients with stage ⅢB and Ⅳ with cisplatin (DDP) and TAX as control. 30 cases in TN group, nedaplatin 30 mg / m2, on days 1 to 3; TAX 175 mg / m2 on day 1; repeated every 4 weeks. TP group, 27 cases, DDP 30 mg / m2, on days 1 to 3; TAX 175 mg / m2 on day 1; repeated every 4 weeks. Results The total effective rates of TN and TP groups were 43.3% and 48.1%, respectively (P = 0.716). The disease control rates were 86.7% and 88.8% respectively (P = 0.799). The median survival of TN and TP patients was 14.3 and 13.0 months (P = .839). The 1-year survival rates were 62.5% and 59.1%, respectively, and the 2-year survival rates were 0 and 5.8%, respectively. The neutropenia and thrombocytopenia in TN group were similar to those in TP group. The TP group had less anemia (38.5% vs 17.5%, P = 0.001), nausea and vomiting (82.6% vs 35.6%, P = 0.000) Reactions (35.9% and 14.1%, P = 0.000) and peripheral puncture toxicity rates (50.0% and 21.9%, P = 0.023) were higher. Conclusion Nedaplatin combined with TAX is an effective regimen for the treatment of NSCLC. It is similar to cisplatin combined with TAX in efficacy and survival, showing some advantages in some side effects.