胸腺五肽甲地孕酮配合EP方案与单纯EP方案治疗晚期非小细胞肺癌对比研究.docVIP

胸腺五肽甲地孕酮配合EP方案与单纯EP方案治疗晚期非小细胞肺癌对比研究 　　【摘要】 目的 比较TM-NP方案[Timoepntin(胸腺五肽)、MA(megestrol acetate,甲地孕酮)、与DDP联合的生物化疗方案]与EP方案(即VP16加DDP的单纯化疗方案)对初治Ⅲb-Ⅳ期非小细胞肺癌(NSCLC)患者的疗效、毒性及生活质量的改善情况。方法 A组(33例)接受TM-NP方案治疗;B组(35例)接受EP方案治疗。两组均以4周为1周期,重复3个周期。客观疗效与毒性反应按WHO标准进行评价,生活质量根据临床受益疗效来评价。结果 A、B两组客观疗效(CR+PR)分别为27.3%及22.9%,P0.05;中位生存期A组32周,B组27周(P0.01);白细胞减少及恶心呕吐反应B组均较A组明显(P0.01);短暂性寒战、发热症状多见于A组(P0.01);两组均未发现其他严重的毒性反应。临床受益疗效A组高于B组(P0.05)。结论 胸腺五肽、甲地孕酮配合NP方案与单纯EP方案治疗晚期NSCLC的客观疗效无明显差异性,但前者毒副反应小,中位生存期长,患者生活质量改善明显。 　　【关键词】 胸腺五肽;甲地孕酮;EP方案;非小细胞肺癌;临床受益疗效 　　 　　Comparative Study of Timoepntin and Megestrol Acetate P1us EP Regimen with EP Regimen Alone in the Treatment Of Advanced Non-small Cell Lung Cancer 　　 　　【Abstract】 Objective To compare the effect,toxicity and quality of life(QOL)between IM-EP regimen and EP regimen alone in primary patients with advanced non-small cell lung cancer(NSCLC,stage IIIb-IV),Methods Group A(33 cases) were treated with TM-EP regimen and group B(35cases)were treated with EP regimen.Both regimens were reepated every 4 weeks for three cycles,Objective tumor response and cytotoxic reactions were assessed by WHO criteria.QOL was evaluated by clinical benefit response.Results The objective response rate(CR+PR)was 27,3 % in group A compared to 22.9 % in group B(P0.05).The median survival time was 32 weeks in group A compared to 27 weeks in group B(P0.01). Leukovenia,nausea and vomiting in group B were more serious than those in group A(P0.01),but transient fever and chill were much more common in group A. 　　【Key words】 　　Interferon-alb;Megesteol acetate;EP regimen;Non-small cell lung cancer(NSCLC);Clinical benefit response (CBR) 　　 　　作者单位:277100枣庄新中兴公司医院(周忠泉);枣庄矿业集团枣庄医院(王传金) 　　 　　肺癌是全世界最常见的恶性肿瘤。据世界卫生组织1985年的统计数字显示,当年的肺癌新病例有89.6万例,占所有癌症的11.8%。近20年的追踪发现,每年的肺癌新病例以大约0.5%的速率在增长,目前已成为严重危害人民生命和健康的常见病。 　　非小细胞肺癌(Non Small Cell Lung Cancer,NSCLC)是指除了小细胞肺癌以外的所有类型的肺癌,占所有肺癌的75%～80%。此类肺癌的治疗多采用以手术治疗为主的治疗方法。大约30%～40%的NSCLC患者在诊断时已经出现远处转移病灶,对晚期或转移性患者如不做抗肿瘤治疗而仅给予对症治疗(Best Supp