论文部分内容阅读
目的观察顺铂(DDP)联合长春瑞宾(NVB)与顺铂联合紫杉醇(Taxel)治疗晚期非小细胞肺癌(NSCLC)患者的临床疗效及不良反应。方法中晚期NSCLC患者80例,分别接受顺铂+长春瑞宾(PN)治疗40例,顺铂+紫杉醇(PT)治疗40例,化疗方案:PN为顺铂:30mg/m2,静脉滴注,第2~4天,长春瑞宾30mg/m2,静脉注射,第1、8天,21d为1周期;PT为顺铂30mg/m2,静脉滴注,第1~3天,紫杉醇175mg/m2,静脉滴注,第1天,21d为1周期。按WHO疗效及不良反应评价标准评价,完成治疗2个周期以上的患者进行临床疗效及不良反应评估。结果可评价患者80例,其中PN组40例,有效(RR)率27.5%(11/40),完全缓解(CR)2例,部分缓解(PR)9例,中位缓解期为6个月,1年生存率37.5%(15/40);PT组40例,RR11例(27.5%),PR11例,中位缓解期为7.5个月,1年生存率47.5%(19/40)。两组有效率、中位缓解期、1年生存率统计学处理无差异(均P>0.05)。两组共完成245周期化疗(PN组123周期,PT组122周期),主要不良反应为骨髓抑制、胃肠道反应、末梢神经炎、肌肉/关节酸痛,其中较为严重Ⅲ、Ⅳ度骨髓抑制,PN组多于PT组,分别为92例次(74.8%)和25例次(20.5%)(P<0.05),而PT组的末梢神经炎、肌肉/关节酸痛重于PN组,分别为58例次(47.5%)、21例次(17.1%)、48例次(39.3%)和25例次(20.3%),2组比较均有差异(均P<0.05),胃肠道反应两组差别不大。结论PN方案与PT方案具有相近的临床疗效,PN组的骨髓抑制重于PT组,而PT组的末梢神经炎、肌肉/关节酸痛重于PN组,两组的胃肠道反应差别不大,若考虑经济,仍主张PN方案为治疗中晚期NSCLC患者的首选方案。
Objective To observe the clinical efficacy and side effects of cisplatin (DDP) plus vinorelbine (NVB) and cisplatin combined with Taxel in patients with advanced non-small cell lung cancer (NSCLC). Methods Forty patients with advanced NSCLC were treated with cisplatin + vinorelbine (PN) 40 and cisplatin + paclitaxel (PT) 40 respectively. The chemotherapy regimen: PN was cisplatin 30 mg / m2, intravenous drip, 2 to 4 days, vinorelbine 30mg / m2, intravenous injection, the first 1,8 days, 21d for a cycle; PT for cisplatin 30mg / m2, intravenous drip, 1 to 3 days, paclitaxel 175mg / m2, Intravenous infusion, the first day, 21d for a cycle. According to WHO evaluation of efficacy and adverse reactions evaluation, completed more than 2 cycles of treatment of patients with clinical efficacy and adverse reaction assessment. Results Eighty patients were evaluated, including 40 in PN group, 27.5% (11/40) in RR group, 2 in complete remission (CR) and 9 in partial remission (PR). The median remission was 6 months Year survival rate was 37.5% (15/40). There were 40 cases in PT group, 11 cases in RR11 (27.5%) and 11 cases in PR. The median survival time was 7.5 months and the 1-year survival rate was 47.5% (19/40). There was no difference between the two groups in the effective rate, the median remission rate and the 1-year survival rate (all P> 0.05). The two groups were completed a total of 245 cycles of chemotherapy (PN group 123 cycles, PT group 122 cycles), the main adverse reactions were bone marrow suppression, gastrointestinal reactions, peripheral neuritis, muscle / joint pain, of which more severe grade Ⅲ, Ⅳ myelosuppression, PN (74.8%) and 25 cases (20.5%) respectively (P <0.05), while PT group had more peripheral neuritis and muscle / joint pain than PN group, which were 58 cases (47.5%), 21 cases (17.1%), 48 cases (39.3%) and 25 cases (20.3%). The difference between the two groups was not significant Big. Conclusion PN and PT have similar clinical curative effect. The bone marrow suppression of PN group is heavier than that of PT group. However, peripheral neuritis and muscle / joint pain in PT group are more severe than PN group. There is little difference in gastrointestinal reaction between PN group and PT group. Considering the economy, still advocate the PN program for the treatment of advanced patients with NSCLC preferred option.