Gao Yong, Shi Zhao-Quan, Cao Chuan-Wu, Zhu Chang-Li, Guo Jing
Department of Medical Oncology, The Fifth People's Hospital, Fudan University, Shanghai, P. R. China.
Ai Zheng. 2005 Aug;24(8):985-9.
BACKGROUND & OBJECTIVE: Treating advanced non-small cell lung cancer (NSCLC) is difficult. The response rate (RR) of NSCLC patients to traditional chemotherapy regimen is about 40%. Now the RR has been improved with application of new drugs, such as taxol, docetaxal, and gemzar. This randomized trial was designed to determine treatment efficacies of docetaxol plus cisplatin and gemzar plus cisplatin on advanced NSCLC, and observe their cytotoxicities.
A total of 43 advanced NSCLC patients were randomized into 2 groups, 22 in TP group (docetaxol plus cisplatin) and 21 in GP group (gemzar plus cisplatin), and received relevant treatments. The RR, time to progression (TTP), mean survival time (MST), and 1- and 2-year survival rates of the patients were analyzed.
The RR was 45.4% in TP group with 1 case of complete remission (CR) and 9 cases of partial remission (PR), and 42.9% in GP group with 9 cases of PR. The TTP was 4.6 months in TP group, and 4.7 months in GP group; the MST was 10.6 months in TP group [95% confidence interval (CI), 9.3-11.3 months], and 11.3 months in GP group (95% CI, 6.8-14.8 months). The 1- and 2-year survival rates were 38.1% and 15.3% in TP group, and 34.1% and 11.2% in GP group. The differences of RR and survival rate between the 2 groups were not significant (P=0.71, P=0.89). The major cytotoxicity of TP was leukopeniaû the major cytotoxicities of GP group were fatigue and thrombocytopenia. All adverse reactions were tolerable.
TP and GP regimens may enhance the remission rate of NSCLC patients with tolerable adverse reaction, and improve the short-term survival rate, but the differences in treatment efficacies of TP and GP groups are not significant.
晚期非小细胞肺癌(NSCLC)的治疗颇具难度。NSCLC患者对传统化疗方案的缓解率(RR)约为40%。如今,随着紫杉醇、多西他赛和吉西他滨等新药的应用,RR已有所提高。本随机试验旨在确定多西他赛联合顺铂与吉西他滨联合顺铂治疗晚期NSCLC的疗效,并观察其细胞毒性。
43例晚期NSCLC患者随机分为2组,TP组(多西他赛联合顺铂)22例,GP组(吉西他滨联合顺铂)21例,接受相应治疗。分析患者的RR、疾病进展时间(TTP)、平均生存时间(MST)以及1年和2年生存率。
TP组RR为45.4%,其中完全缓解(CR)1例,部分缓解(PR)9例;GP组RR为42.9%,PR 9例。TP组TTP为4.6个月,GP组为4.7个月;TP组MST为10.6个月[95%置信区间(CI),9.3 - 11.3个月],GP组为11.3个月(95%CI,6.8 - 14.8个月)。TP组1年和2年生存率分别为38.1%和15.3%,GP组分别为34.1%和11.2%。两组RR和生存率差异无统计学意义(P = 0.71,P = 0.89)。TP组主要细胞毒性为白细胞减少,GP组主要细胞毒性为乏力和血小板减少。所有不良反应均可耐受。
TP和GP方案可提高NSCLC患者的缓解率,不良反应可耐受,能改善短期生存率,但TP组和GP组治疗疗效差异无统计学意义。