Department of Thoracic Surgery, Peking University Peoples' Hospital, Beijing, China.
Chin Med J (Engl). 2013;126(11):2087-91.
The combination of cisplatin and vinorelbine is an evidence-supported regimen for adjuvant chemotherapy for treating non-small cell lung cancer (NSCLC). But this doublet has considerable toxicity and unfavorable tolerability, and results in poor compliance. The cisplatin and gemcitabine regimen is one of the most active and well-tolerated regimens against advanced NSCLC, but its toxicity and tolerability has not been adequately evaluated in the adjuvant setting.
From a lung cancer database we retrospectively reviewed NSCLC patients receiving adjuvant chemotherapy of cisplatin (75 mg/m(2)) and gemcitabine (1250 mg/m(2)) between January 2005 and December 2011. Postoperative demographics, compliance to adjuvant therapy and toxicity were retrieved from medical records.
A total of 132 patients met the criteria and were included in the study, 96 were male (72.7%) and 36 were female (27.3%). Median age was 60.5 years old, range 29 - 75 years, and 41.7% of patients were ≥ 65 years old. Overall, 68.2% patients received all four planned cycles, and the cumulative dose delivered for gemcitabine was 8333 mg (83.3% of the planned dose) and cisplatin 248 mg (82.7% of the planned dose). There were no treatment-related deaths. Grade 3/4 neutropenia developed in 47 patients (35.6%) and was the predominant hematologic toxicity. Common grade 3/4 non-hematologic toxicities were nausea/vomiting (22.0%), infection (12.3%), and febrile neutropenia (11.4%).
Cisplatin and gemcitabine are feasible for use in the adjuvant setting with a favorable toxicity profile and superior tolerability compared with published data on cisplatin and vinorelbine.
顺铂和长春瑞滨联合治疗非小细胞肺癌（NSCLC）的辅助化疗是一种有证据支持的方案。但这种联合方案毒性较大，耐受性差，导致患者顺从性较差。顺铂和吉西他滨方案是治疗晚期 NSCLC 最有效、耐受性最好的方案之一，但在辅助治疗中的毒性和耐受性尚未得到充分评估。
我们从肺癌数据库中回顾性分析了 2005 年 1 月至 2011 年 12 月期间接受顺铂（75mg/m2）和吉西他滨（1250mg/m2）辅助化疗的 NSCLC 患者。从病历中检索术后人口统计学资料、辅助治疗的依从性和毒性。
共有 132 例患者符合条件并纳入研究，其中 96 例为男性（72.7%），36 例为女性（27.3%）。中位年龄为 60.5 岁，范围为 29-75 岁，其中 41.7%的患者年龄≥65 岁。总体而言，68.2%的患者接受了所有 4 个计划周期的治疗，吉西他滨的累积剂量为 8333mg（计划剂量的 83.3%），顺铂为 248mg（计划剂量的 82.7%）。无治疗相关死亡。47 例（35.6%）患者发生 3/4 级中性粒细胞减少症，是主要的血液学毒性。常见的 3/4 级非血液学毒性有恶心/呕吐（22.0%）、感染（12.3%）和发热性中性粒细胞减少症（11.4%）。
顺铂和吉西他滨在辅助治疗中是可行的，与已发表的顺铂和长春瑞滨数据相比，具有良好的毒性特征和更好的耐受性。
