Wang Anlan, Zhou Hui, Wen Xiaoping, Yi Qing, Zhou Wenwei, Wang Wei, Yao Dingquan, Xu Jianhua, Huang Zhihua
Department of Medical Oncology, Hunan Cancer Hospital, Changsha, Hunan 410006, P.R.China.
Zhongguo Fei Ai Za Zhi. 2007 Jun 20;10(3):219-22. doi: 10.3779/j.issn.1009-3419.2007.03.13.
Chemotherapy is very important in treatment of advanced non-small cell lung cancer (NSCLC), and the third-generation cisplatin-based chemotherapy regimens have been the standard treatment for advanced NSCLC. The aim of this study is to compare the efficacy and toxicity among four different chemotherapeutic regimens combined with radiotherapy in patients with stage III/IV NSCLC.
A total of 527 patients with stage III/IV NSCLC were enrolled, among whom there were 243 patients received cisplatin/vinorelbine (NP group), 163 patients for cisplatin/paclitaxel (TP group), 65 patients for cisplatin/gemcitabine (GP group) and 56 patients for cisplatin/docetaxel (DP group). The efficacy, side effects, median time to progression (TTP), median survival time (MST), 1- and 2-year survival rate were compared.
The response rate was 46.9% in the NP arm, 44.8% in the TP arm, 47.7% in the GP arm and 42.9% in the DP arm (P > 0.05). The response rate of patients with radiochemotherapy was 69.9%, and 40.8% for those with chemotherapy alone (P < 0.05). In group NP, TP, GP and DP, median TTP was 5.7, 5.3, 5.9 and 5.5 months (P > 0.05) respectively, MST was 10.4, 10.6, 11.5 and 10.4 months (P > 0.05) respectively, 1-year survival rate was 41.9%, 41.1%, 43.1% and 42.9% (P > 0.05) respectively, and 2-year survival rate was 21.3%, 19.4%, 23.1% and 23.2% (P > 0.05) respectively.
The third-generation cisplatin-based chemotherapy regimens may be the standard treatment for advanced NSCLC, and their combination with radiotherapy may improve the therapeutic efficacy and prolong the survival of patients.
化疗在晚期非小细胞肺癌（NSCLC）的治疗中非常重要，基于第三代顺铂的化疗方案一直是晚期NSCLC的标准治疗方法。本研究的目的是比较四种不同化疗方案联合放疗治疗Ⅲ/Ⅳ期NSCLC患者的疗效和毒性。
共纳入527例Ⅲ/Ⅳ期NSCLC患者，其中243例接受顺铂/长春瑞滨（NP组），163例接受顺铂/紫杉醇（TP组），65例接受顺铂/吉西他滨（GP组），56例接受顺铂/多西他赛（DP组）。比较各组的疗效、副作用、中位疾病进展时间（TTP）、中位生存时间（MST）、1年和2年生存率。
NP组的缓解率为46.9%，TP组为44.8%，GP组为47.7%，DP组为42.9%（P>0.05）。放化疗患者的缓解率为69.9%，单纯化疗患者为40.8%（P<0.05）。NP组、TP组、GP组和DP组的中位TTP分别为5.7、5.3、5.9和5.5个月（P>0.05），中位MST分别为10.4、10.6、11.5和10.4个月（P>0.05），1年生存率分别为41.9%、41.1%、43.1%和42.9%（P>0.05），2年生存率分别为21.3%、19.4%、23.1%和23.2%（P>0.05）。
基于第三代顺铂的化疗方案可能是晚期NSCLC的标准治疗方法，其与放疗联合可能提高治疗效果并延长患者生存期。
