澤菲联合盖诺治疗不耐受顺铂晚期非小细胞肺癌临床观察.docVIP

泽菲联合盖诺治疗不耐受顺铂晚期非小细胞肺癌临床观察 福建医科大学教学医院福州肺科医院肿瘤内科 陈 群 李育宏 石 琴 谢 强 陈雨燕 王成辉 王 琳 摘要 目的 观察并评价泽菲联合盖诺治疗不能耐受顺铂的晚期非小细胞肺癌的疗效和毒性。方法 108例Ⅲ和Ⅳ期非小细胞肺癌既往均未曾放疗或化疗，按ECOG计分≤2，生存期超过三个月。WBC计数＞4.0×109 / L，肝、肾功能生化指标正常，未有活动性感染征象。36例以泽菲联合盖诺（GN）为一线方案，另外36例以吉西他滨加顺铂（GP），36例以长春瑞滨加顺铂（NP）为一线方案作对照组。结果 GP组、NP组和GN组RR%分别为44.4%、41.7%和36.1%，三组疗效比较，x2 = 0.421，P = 1.731，（P值＞0.05）无统计学差异性。三组的症状缓解率、全身体力状况改善、TTP、一年生存率等亦无显著性差异。GN组与另两组在Ⅲ~Ⅳ度血液学毒性方面比较无统计学差异（P＞0.05）；GN组非血液学毒性比较少，生活质量的影响较少，均有统计学差异性。结论 GN方案疗效较好，毒性较低，具有良好耐受的方案，尤其适合于不能耐受顺铂的晚期NSCLC患者。 关键词 非小细胞肺癌；化学疗法；吉西他滨；长春瑞滨； Gemcitabine plus vinorelbine in the treatment of advanced non-small cell cancer unendurable cisplatinum-based chemotherapy CHEN qun , LI yu hong , SI qing , XIE qiang , CHEN yu yan , WANG chen hui , WANG lin . Department of Tomour , Fuzhou Pulmonary Hospital , Fuzhou 350008 , China . [Abstract] Objective To evaluate the efficacy and toxicity of gemcitabine plus vinorelbine in the treatment of advanced non-small cell cancer ( NSCLC ) unendurable cisplatinum-based chemotherapy . Methods 108 patients of the stage 3 and 4 NSCLC with ECOG counts ≤ 2 point , survival time more than three months , counts of WBC ＞ 4.0×109 / L ,function of liver and kidney are normal , no infect symptom . all patients treated previously without radiotherapy and chemotherapy , in those 36 patients treated with gemcitabine plus vinorelbine ( GN ) , another 36 patients treated with gemcitabine plus cisplatin ( GP ) ,and 36 patients vinorelbine plus cisplatin . Results The overall response rates were 44.4% in the group GP , 41.7% in the group NP and 36.1% in the group GN . No statistical difference in the RR between three methods of chemotherapy , (x2 = 0.421 , P = 1.731 , P＞0.05 ) . Also that in the Time To Progress , Life Quality , Symptomatic Respond and the Year Survival Rate . Toxicity of Ⅲ~Ⅳ degree haematology were indistinguishably between the group GN and the another two groups ( P＞0.05 ) . Toxicity of non- haematology of the group GN were ma