顺铂联合吉西他滨与联合紫杉醇治疗晚期非小细胞肺癌疗效分析

摘要

Objective:To observe the efficacy and side effects of cisPlatin in combination with gemcitabine or Pa-clitaxel in advanced Patients with non - small cell lung cancer(NSCLC). Methods:All 200 cases of advanced NSCLC who were confirmed by Pathology or cytology were enrolled into two grouPs randomly:the grouP of gemcitabine(GP) and the grouP of Paclitaxel(TP),each had 100 Patients. The grouP of GP:received gemcitabine 1000mg/ m2 ,d1 and d8 ,and cisPlatin 50mg/ m2 ,d2 - d4 ,both with intravenous infusion. The grouP of TP:Paclitaxel 150mg/ m2 ,d1 ,cisPla-tin 60mg/ m2 ,d1 - d3 ,21 days for 1 circle. To evaluate efficacy after two cycles. Results:Total effective rate(PR +CR)was 50% in TP grouP vs 30% in GP grouP,the one - year survival rate was 41% in TP grouP vs 36% in GP grouP. There was significant difference in the overall resPonse rate(P = 0. 035),but no significant difference in the one - year survival rate(P = 0. 745). The adverse reactions of two grouPs were different. ThrombocytoPenia adverse effects in the GP grouP were much higher than in the TP grouP while muscle arthrosis Pain and vomiting was rather the contrary. Conclusion:The efficacy of cisPlatin in combination with Paclitaxel in the treatment is better than with Pacli-taxel,but the adverse effects are stronger.%目的：观察顺铂联合吉西他滨以及顺铂联合紫杉醇治疗晚期非小细胞肺癌疗效以及毒副反应。方法：经病理组织学或细胞学证实的200例晚期非小细胞肺癌患者，随机分为吉西他滨组（GP 组）与紫杉醇组（TP 组）各100例。GP 组：吉西他滨1000mg/ m2，d1与 d8，顺铂50mg/ m2，d2- d4，均静脉滴注；TP 组：紫杉醇150mg/ m2，d1，顺铂60mg/ m2，d1- d3。两组患者均每21天为一个周期，连用二个周期以上。结果：TP 组总有效率（PR + CR）为50%，1年生存率为41%；GP 组总有效率（PR + CR）为30%，1年生存率为36%。两组患者有效率有显著性差异（P ＝0.035），1年生存率无显著差异（P ＝0.745）。两组主要毒副反应不同，GP 组血小板减少显著高于 TP 组，而 TP 组肌肉关节疼痛与呕吐显著高于 GP 组。结论：顺铂联合紫杉醇方案治疗效果优于顺铂联合吉西他滨方案，但是毒副反应较强。