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吉西他滨联合顺铂一线治疗79例晚期非小细胞肺癌的临床报告

[Clinical report of combined chemotherapy with gemcitabine plus cisplatin as first-line treatment to 79 cases of advanced non-small cell lung cancer].

作者信息

Lin Lin, Hao Xuezhi, Li Junling, Wang Ziping, Wang Yan, Wang Hongyu, Hu Xingsheng, Zhang Xiangru

机构信息

Department of Medical Oncology,Cancer Hospital/Institute,Chinese Academy of Medical Sciences &PUMC,Beijing 100021,P.R.China.

出版信息

Zhongguo Fei Ai Za Zhi. 2007 Dec 20;10(6):513-9. doi: 10.3779/j.issn.1009-3419.2007.06.14.

Abstract

BACKGROUND

Chemotherapy is the main treatment measure of advanced non-small cell lung cancer(NSCLC).The aim of this study is to explore the efficacy,toxicity,time to disease progression(TTP) and overall survival under the combined chemotherapy with gemcitabine(GEM) plus cisplatin(DDP) in the treatment of advanced NSCLC.

METHODS

Retrospective review was conducted on 79 chemotherapy-naive cases of advanced NSCLC treated with GEM and DDP from October 1999 to November 2005.Among 79 patients,51 were male and 28 female;the median age was 53 years old(ranged from 21 to 74);there were 17 cases of squamous cell carcinoma,53 cases of adenocarcinoma,3 cases of large cell carcinoma,1 case of adeno-sqamous cell carcinoma,5 unidentified cases;there were 26 cases in IIIB stage and 53 cases in IV stage according to AJCC 1997 standard.All patients received GEM 800-1250 mg/m² on days 1 and 8 and DDP 75-80 mg/m² on day 1 or 30 mg/m² for three days by intravenous administration,with 21 days as one cycle.Each patient received 2-4 cycles chemotherapy.

RESULTS

The total clinical reponse rate(complete and partial response) was 31.6%,and clinical benefit rate(complete and partial response and stable disease) was 73.4%.1-year survival rate was 64.9%,2-year survival rate was 32%.After median follow-up of 2.33 years,median TTP was 5.06 months.The main toxicities were nausea,vomitting and hematological toxicities.The rates of grade III to IV leukopenia and thrombocytopenia were 25.4% and 31.6% respectively.Other toxicities were slight and tolerable.

CONCLUSIONS

Combined chemotherapy with GEM plus DDP as first-line treatment to advanced NSCLC is an effective and feasible regimen,which is one of the standard regimens.For old patients,this regimen is a good choice.The fit dosage of GEM for Chinese is 1000 mg/m².

摘要

背景

化疗是晚期非小细胞肺癌(NSCLC)的主要治疗手段。本研究旨在探讨吉西他滨(GEM)联合顺铂(DDP)化疗方案治疗晚期NSCLC的疗效、毒性、疾病进展时间(TTP)及总生存期。

方法

回顾性分析1999年10月至2005年11月期间79例初治晚期NSCLC患者采用GEM与DDP联合化疗的情况。79例患者中,男性51例,女性28例;中位年龄53岁(21~74岁);鳞癌17例,腺癌53例,大细胞癌3例,腺鳞癌1例,未明确类型5例;按1997年AJCC标准,ⅢB期26例,Ⅳ期53例。所有患者均在第1天和第8天静脉滴注GEM 800~1250mg/m²,第1天静脉滴注DDP 75~80mg/m²或第1~3天静脉滴注DDP 30mg/m²,21天为1个周期。每位患者接受2~4个周期化疗。

结果

总临床缓解率(完全缓解和部分缓解)为31.6%,临床获益率(完全缓解、部分缓解和疾病稳定)为73.4%。1年生存率为64.9%,2年生存率为32%。中位随访2.33年,中位TTP为5.06个月。主要毒性反应为恶心、呕吐及血液学毒性。Ⅲ~Ⅳ度白细胞减少和血小板减少发生率分别为25.4%和31.6%。其他毒性反应轻微,患者可耐受。

结论

GEM联合DDP一线治疗晚期NSCLC是一种有效可行的方案,是标准方案之一。对于老年患者,该方案是较好的选择。中国患者GEM的适宜剂量为1000mg/m²。

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