背景与目的 化疗是目前晚期非小细胞肺癌主要的治疗手段,非铂两药方案因避免了严重的肝肾毒性,成为常见的治疗选择.本研究回顾性分析晚期非小细胞肺癌一线使用吉西他滨+长春瑞滨(GN)方案的患者,探讨该方案的疗效和安全性.方法 通过非干预的方式收集国内5家医院在2004年1月1日-2010年6月30日行GN方案一线治疗的晚期非小细胞肺癌患者,统计患者的疗效及毒副反应.应用Kaplan-Meier法进行生存分析,Cox方法对影响患者疗效的年龄、性别、分期、病理类型等进行多因素分析.结果 共67例患者采用了GN方案,52例为RRM1阴性和ERCC1阳性患者,其余15例患者未行RRM1和ERCC1测定.其一线治疗的客观缓解率为34.3％,疾病控制率为76.1％,中位无进展生存期为5.5个月,中位总生存期为22.1个月,多数患者的毒副反应可以耐受.体能状况评分、是否后续治疗对患者的生存期有明显影响.结论 GN方案在晚期非小细胞肺癌一线治疗中有较好的疗效和安全性.%Background and objective Chemotherapy has become the mainstay of first-line therapy. Non-platinum containing drugs are characterized by favorable toxiriry profiles and is better tolerated than platinum-based regimens. The aim of this study is to detect the efficacy and toxicity of gemcitabine and vinorelbine (GN) in advanced non-small cell lung cancer (NSCLC) first-line treatment in China. Methods We retrospectively reviewed 67 NSCLC patients treated with this agent at five Hospital in China from Jan 2004 to Jun 2010. Survival analysis was evaluated by Kaplan-Meier method, multivari-ate analyses were performed to find prognostic markers using Cox proportional hazards model. Results A total of 67 patients were analyzed in this study. There were 52 patients with RRM1 negative and ERCC1 positive. The objective response rate was 34.3%. The disease control rate was 76.1%. The progression-free survival and median overall survival was 5.5 and 22.1 months, respectively. On multivariate analysis, performance status score and whether further treatment were independent prognostic factor for overall survival. Conclusion The GN agent is effective for the first line treatment in advanced non-small cell lung cacer. The toxicity is well tolerated.
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