武玮, 朱允中, 徐丽艳, 唐俊舫, 刘喆, 刘赞. 健择顺铂一线治疗晚期非小细胞肺癌50例[J]. 中国肿瘤临床, 2008, 35(17): 991-994.
引用本文: 武玮, 朱允中, 徐丽艳, 唐俊舫, 刘喆, 刘赞. 健择顺铂一线治疗晚期非小细胞肺癌50例[J]. 中国肿瘤临床, 2008, 35(17): 991-994.
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WU Wei, ZHU Yunzhong, XU Liyan, TANG Junfang, LIU Zhe, LIU Zan. Clinical Evaluation of the Efficacy of Gemcitabine plus Cisplatin in the Treatment of 50 Cases of Advanced Non-small-cell Lung Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 35(17): 991-994.
Citation: WU Wei, ZHU Yunzhong, XU Liyan, TANG Junfang, LIU Zhe, LIU Zan. Clinical Evaluation of the Efficacy of Gemcitabine plus Cisplatin in the Treatment of 50 Cases of Advanced Non-small-cell Lung Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 35(17): 991-994.
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健择顺铂一线治疗晚期非小细胞肺癌50例

Clinical Evaluation of the Efficacy of Gemcitabine plus Cisplatin in the Treatment of 50 Cases of Advanced Non-small-cell Lung Cancer

    摘要
  • 摘要: 目的 :比较健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的疗效和不良反应,分析50例患者的生存及影响因素。 方法 :50例入选患者均为经病理和细胞学证实的初治晚期非小细胞肺癌,临床上有可测量病灶,摘要 目的 :比较健择联合顺铂治疗晚期非小细胞肺癌3周和4周方案的疗效和不良反应,分析50例患者的生KPS≥80分,肝肾功能基本正常。3周方案:GEM1250mg/m2,d1、8,DDP75mg/m2,d1,每21天为一周期。4周方案:GEM1000mg/m2,d1、8、15,DDP75mg/m2,d1,每28天为一周期。 结果 :50例患者总有效率30.0%(15/50),其中4周方案有效率27.3%(6/22),3周方案有效率32.1%(9/28),(P>0.05);生存期:50例患者中位生存期为9.3个月(2.1-38.8),其中4周方案11.7个月,3周方案8.9个月。中位TTP4.1个月(1.2-24.0),其中4周方案3.3个月,3周方案4.2个月,差异均无显著性意义(P>0.05);应用COX回归分析显示一线化疗疗效及后继治疗可明显影响患者生存期,化疗方案为3患者生存(周或4周对患者生存的影响差异无显著性意义,后继治疗中含靶向治疗较不含靶向治疗及最佳支持治疗明显改善 结论 :健择顺铂方案治疗晚期NSCLC有较佳疗效,3周方案与4周方案的疗效相似,以3周方案副反应较少,后继治P=0.000);主要不良反应是白细胞、中性粒细胞、血小板和血红蛋白减少等,两组间的反应无显著差异。疗应用酪氨酸激酶抑制剂亦有可能改善患者生存期。

     

    Abstract: Objective : To compare the efficacy and safety between 3-week schedule and 4-week schedule of gemcitabine plus cisplatin in the treatment of advanced non-small-cell lung cancer (NSCLC) and to evaluate the survival data of the 50 patients. Methodse : A total of 50 chemonaive NSCLC patients of stage ⅢB-IV, KPS≥ 80, measurable lesions and good liver and renal function were enrolled. Three-week schedule was given with Gemcitabine (GEM 1250 mg/M2) on day l and day 8 plus Cisplatin (DDP 75mg/m2) on day l. The cycle was repeated every 21 days. Fourweek schedule was given with Gemcitabine (GEM 1000 mg/m2) on day l, day 8 and day 15 plus Cisplatin (DDP 75 mg/m2) on day l. The cycle was repeated every 28 days. Results : The overall response rate was 30.0% (15/50) in all of the 50 patients, 27.3% (6/22) in the 4-week schedule group and 32.1% (9/28) in the 3-week schedule group, with no significant difference (P>0.05). The mean survival time was 8.9 months in the 3-week schedule group and 11.7 in the 4-week schedule group (P>0.05). The TTP was 4.2 months in the 3-week schedule group and 3.3 months in the 4-week schedule group (P>0.05). Cox regression analysis indicated that the efficacy of first-line chemotherapy and the following therapy significantly influenced patient survival. No significant difference was found in patient survival between the 3-week and 4-week schedule. Targeted therapy included in the following therapy significantly influenced the patient survival (P=0.000). The main side effects included leucocytopenia, granulocytopenia, thrombocytopenia, anorexia and nausea, with no significant difference between the 3-week schedule group and the 4-week schedule group. Conclusion : The combination of Gemcitabine and Cisplatin is an effective regimen in the treatment of advanced non-small-cell lung cancer. The 3-week schedule and the 4-week schedule have similar efficacy. The 3-week schedule cause less side effects than the 4-week schedule. The EGFR tyrosine kinase inhibitor included in the following therapy may improve the overall survival.

     

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