论文部分内容阅读
背景与目的化疗在晚期非小细胞肺癌(NSCLC)的治疗中占有极为重要的地位,以铂类药物为基础的第三代化疗方案已成为晚期NSCLC的标准方案。本研究的目的是比较四种含铂方案治疗Ⅲ/Ⅳ期NSCLC的疗效和毒副反应。方法527例Ⅲ/Ⅳ期NSCLC患者分别非随机接受TP(紫杉醇+顺铂)、NP(长春瑞滨+顺铂)、GP(吉西他滨+顺铂)、DP(多西紫杉醇+顺铂)方案化疗,其中NP方案243例,TP方案163例,GP方案65例,DP方案56例,评价四种化疗方案的远期疗效、毒副反应、中位疾病进展时间(TTP)、中位生存时间(MST)及生存率。结果NP、TP、GP、DP组有效率分别为46.9%、44.8%、47.7%、42.9%(P>0.05)。化疗+放疗综合治疗与单纯化疗患者的有效率分别为69.9%、40.8%(P<0.05)。NP、TP、GP、DP组中位TTP分别为5.7、5.3、5.9、5.5个月,MST分别为10.4、10.6、11.5、10.4个月,1年生存率分别为41.9%、41.1%、43.1%、42.9%,2年生存率分别为21.3%、19.4%、23.1%、23.2%,四组间差异均无统计学意义(P>0.05)。结论含铂类的第三代化疗方案是晚期NSCLC的标准治疗方案,化疗加放疗的综合治疗可能提高疗效,延长患者的生存期。
Background and Objective Chemotherapy plays a very important role in the treatment of advanced non-small cell lung cancer (NSCLC). The third-generation platinum-based chemotherapy has become the standard protocol for advanced NSCLC. The purpose of this study was to compare the efficacy and side effects of four platinum-containing regimens for stage III / IV NSCLC. Methods A total of 527 patients with stage Ⅲ / Ⅳ NSCLC were randomly assigned to receive chemotherapy with TP (paclitaxel + cisplatin), NP (vinorelbine + cisplatin), GP (gemcitabine + cisplatin) and DP , Including 243 cases of NP, 163 cases of TP, 65 cases of GP and 56 cases of DP. The long-term efficacy, toxicity, median time to progression (TTP), median survival time MST) and survival rate. Results The effective rates of NP, TP, GP and DP groups were 46.9%, 44.8%, 47.7% and 42.9%, respectively (P> 0.05). The effective rates of chemotherapy + radiotherapy combined with chemotherapy alone were 69.9% and 40.8%, respectively (P <0.05). The median TTP in NP, TP, GP and DP groups were 5.7, 5.3, 5.9 and 5.5 months, respectively, with MSTs of 10.4, 9.6, 11.5 and 10.4 months respectively. The 1-year survival rates were 41.9%, 41.1% and 43.1% , 42.9% respectively. The 2-year survival rates were 21.3%, 19.4%, 23.1% and 23.2% respectively. There was no significant difference between the four groups (P> 0.05). Conclusion The third generation chemotherapy regimen containing platinum is the standard treatment for advanced NSCLC. Combined chemotherapy and radiotherapy may improve the curative effect and prolong the survival of patients.