奈达铂治疗晚期非小细胞肺癌临床观察

摘要

目的:观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性.方法:60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组(GN组)30例,吉西他滨1 000mg/m2,第1、8天,静脉滴注30分钟,奈达铂80mg/m2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组(GP组)30例,吉西他滨1 000mg/m2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/ m2,分3d,常规水化利尿.以上2组方案均21天为一个周期.结果:GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异(P＞0.05);GP组胃肠道反应(80%)发生率明显高于GN组(56.7%)(P＜0.05);两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显(P＞0.05);血小板下降GN组(73.3%)较GP组(66.7%)显著(P＞0.05),但无统计学差异.结论:吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应.%Objective:To observe the efficacy and side effects of gemcitabine combined with nedaplatin and cisplatin in the treatment of advanced non - smal cell lung cancer( NSCLC ). Methods: A total of 60 patients with advanced non - small cell lung cancer were divided into the gemcitabine combined with nedaplatin group( group GN, n = 30 ):Gemcitabine 1 000mg/m2 , d1 ,8, iv drip; nedaplatin 80mg/m2 , d2, iv drip;And the gemcitabine combined with cisplatin group( group GP, n = 30 ). Gemcitabine 1 000mg/m2 , d1,8, iv drip; cisplatin80 - 100 mg/m2 , divided into three day-s to iv drip. All patients were undergone 2 cycles, each cycle 21 day-s. Results: The efficacy of group GN was 36.67％ and group GP was 40.00％ , there was no significant difference between the two group in curative effect( P ＞0.05 ). A higher response rate of digestive reaction( 80.0％ ) occurred in group GP, compared to that occurred in group GP ( 56.7％ ) ,with a significant difference between the two groups( P ＜ 0.05 ). There was no significant difference between two groups in the toxicity- of kidney. There was a lower incidence of leucopenia response rate ( 50.0％ )in group GP than in group GN ( 56.7％ ),but no significant difference between the groups( P ＞0.05 ). There was a lower thrombocytopenia response rate ( 66.7％ ) in group GP than in group GN ( 73.3％ ),but no significant difference between the groups( P ＞ 0.05 ). Conclusion: There is no significant difference between gemcitabine combined with cisplatin group and nedaplain group in the effect and there is a lower digestive reaction than cisplatin group. the main adverse reaction was mnyelosuppression and allergic reaction,in the treatment of NSCLC.