顺铂联合吉西他滨或多西他赛对晚期非小细胞肺癌的近期疗效和不良反应的观察

摘要

目的 比较顺铂联合吉西他滨或多西他赛治疗晚期非小细胞肺癌的近期疗效和不良反应.方法 选取浙江省舟山医院2009年1月至2012年3月晚期非小细胞肺癌化疗初治患者120例,完全随机分为GP组(吉西他滨±顺铂)和DP组(多西他赛±顺铂),每组60例.2组均给予顺铂30 mg/m2,静脉滴注,第1～3天;GP组给予吉西他滨1 000 mg/m2,静脉滴注30 min,第1、8天;DP组给予多西他赛75 mg/m2,静脉滴注60 min,第1天.21 d为1个周期,共化疗2个周期.评价近期疗效和不良反应.结果 2组均无完全缓解病例.GP组和NP组的总缓解率分别为41.7％ (25/60)和43.3％(26/60),差异无统计学意义(P＞0.05).GP组白细胞下降、肌肉酸痛的发生率明显低于DP组,差异有统计学意义[白细胞下降:63.3％ (38/60)比81.7％(49/60),肌肉酸痛:0比31.7％ (19/60),P＜0.05];血小板减少、皮疹的发生率明显高于DP组,差异有统计学意义[血小板减少:73.3％ (44/60)比33.3％(20/60),皮疹:36.7％(22/60)比0,P＜0.05].结论 以顺铂为基础联合吉西他滨或多西他赛的双药化疗方案的近期疗效相当,不良反应各有侧重点,化疗过程中对不良反应应针对性地观察、预防和治疗.%Objective To observe the efficacy and toxicity of cisplatin combined with gemcitabine or docetaxel in the treatment of advanced non-small cell lung cancer (NSCLC).Methods In Zhoushan Hospital from January 2009 to March 2012 120 patients were randomly divided into the group GP(gemcitabine ± cisplatin) and group DP(docetaxel ± cisplatin),each with 60 cases.Two groups were treated with cisplatin 30 mg/m2,intravenous drip,days 1-3; group GP received gemcitabine 1 000 mg/m2,intravenous infusion of 30 min,days 1,8;group DP was treated with docetaxel 75 mg/m2,intravenous infusion of 60 min,day 1.21 d for 1 cycle,a total of 2 cycles of chemotherapy.The efficacy and toxicity reaction were evaluated.Results The 2 groups had no complete remission.In group GP and group NP,over all remission rate was 41.7％ (25/60) and 43.3％ (26/60),no significant difference (P ＞ 0.05).In group GP,the decrease of white blood cells,muscle soreness was significantly lower than that in group DP,the difference was statistically significant [the decrease of white blood cells:63.3％ (38/60) vs 81.7％ (49/60),muscle soreness:0 vs 31.7％ (19/60),P ＜0.05] ; thrombopeny,rash was significantly higher than that in group DP,the difference was statistically significance [thrombopeny:73.3％ (44/60) vs 33.3 ％ (20/60),rash:36.7％ (22/60) vs 0,P ＜ 0.05].Conclusion Cisplatin has the short-term effect of dual drug chemotherapy combined with gemcitabine or docetaxel; the emphasis of toxicity during chemotherapy,the toxicity should be targeted with observation,prevention and treatment.