吉西他滨联合长春瑞滨治疗铂类耐药中晚期非小细胞肺癌23例

摘要

Objective:To value the the efficacy and toxicities of gemcitabine(GEM)associated with navelbine(NVB)(GN protocol)on treatment of patients with advanced non-small cell lung cancer(NSCLC)resistant to platinum.Methods:Twenty-three cases of NSCLC anciently treated with platinum for two cycles with no obvious therapeutic effect were treated with GN.The details on the therapy are as follows:GEM was taken through the intravenous dripping at 1 000 mg/m2 on the day 1st and day 8th while NVB was taken through the intravenous dripping at 25 mg/m2 on the day 1st and day 8th.Results:These patients who were treated with GN were acquired 39.1% of the total effective rate,9.8 months of the median survival time,5.7 months of the illness advancing time and 45.8% of one-year survival rate.The major toxicity lies with the hematology,it is manifested by 78.3% of the decrease on the white cellⅠ～Ⅱ,13.0% of the decrease on the white cell Ⅲ～Ⅳ,43.5% of theⅠ～Ⅱ decrease on the platelet and 30.4% of anemia.The toxicity in the non-hematology includes vomiting,nausea and local phlebitis and so on.Conclusions:GN protocol with GEM associated with NVB has a superior therapeutic effect on advanced NSCLC resistant to Platinum with endurable side effects,which is worth popularizing and applying in the clinic.%目的:评价吉西他滨(GEM)与长春瑞滨(NVB)联合(GN方案)治疗对铂类方案耐药的中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及毒副反应.方法:23例既往接受铂类治疗2周期以上无效的中晚期NSCLC患者,改为GN方案治疗.具体为吉西他滨1 000 mg/m2静脉滴注d1、d8;长春瑞滨25 mg/m2静脉滴注d1、d8.结果:23例对铂类耐药的中晚期NSCLC患者经本方案治疗后,总有效率39.1%,中位生存期9.8个月,疾病进展时间为5.7个月,1年生存率45.8%,主要不良反应是血液学毒性,表现为Ⅰ～Ⅱ度白细胞减少78.3%,Ⅲ～Ⅳ度白细胞减少13.0%,Ⅰ～Ⅱ度血小板减少和红细胞减少分别为43.5%和30.4%;非血液学毒性包括Ⅰ～Ⅱ度的恶心、呕吐、局部静脉炎等.结论:GN方案对铂类方案耐药的中晚期NSCLC疗效较好,毒副反应可以耐受,值得在临床上推广和应用.