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不同铂类联合化疗方案治疗晚期非小细胞肺癌患者的疗效与毒性

[Efficacies and toxicities of different platinum-based combination chemotherapies for patients with advanced non-small cell lung cancer].

作者信息

Liu Juan, Ji Fuyun, Li Jin, Wang Bin, Wu Guoming

机构信息

Institute of Respiratory Diseases of PLA,Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.

Institute of Respiratory Diseases of PLA,Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2014 Mar 4;94(8):580-3.

Abstract

OBJECTIVE

To explore the efficacies and toxicities of different platinum-based combination chemotherapeutic regiments for patients with advanced non-small cell lung cancer (NSCLC).

METHODS

A total of 239 advanced NSCLC from January 2011 to December 2012 were reviewed in Xinqiao Hospital. The chemotherapeutic efficacies and adverse effects in the first-line treatment of advanced NSCLC by paclitaxel plus platinum (paclitaxel group, n = 113), gemcitabine plus platinum (gemcitabine group, n = 72) and docetaxel plus platinum (docetaxel group, n = 54) regiments were retrospectively analyzed and compared. Their efficacies and toxicities were analyzed by Chi-square test. And survival was estimated with Kaplan-Meier method.

RESULTS

The objective response rate (ORR) of three groups were 42.5%, 43.1% and 35.2% respectively (P = 0.612). The disease control rate (DCR) were 84.1%, 75.0% and 74.1% respectively (P = 0.198). The median progression-free survival was 5.6, 5.8 and 3.2 months respectively (P = 0.000). The major adverse effects were myelosuppression, gastrointestinal reaction, alopecia and neurotoxicity, etc. The incidence rate of neurotoxicity among three groups were 34.5% (39/113), 11.1% (8/72) and 18.5% (10/54) respectively (P = 0.001).No significant inter-group difference of adverse effects existed (all P > 0.05), except for neurotoxicity.

CONCLUSIONS

Three platinum-based combination chemotherapeutic regiments produce excellent efficacies with acceptable adverse effects. Their ORR and DCR were similar. And the median progression-free survival of paclitaxel and gemcitabine groups is significantly longer than that of docetaxel group.

摘要

目的

探讨不同铂类联合化疗方案治疗晚期非小细胞肺癌(NSCLC)患者的疗效及毒性。

方法

回顾性分析新桥医院2011年1月至2012年12月收治的239例晚期NSCLC患者。对紫杉醇联合铂类(紫杉醇组,n = 113)、吉西他滨联合铂类(吉西他滨组,n = 72)和多西他赛联合铂类(多西他赛组,n = 54)方案一线治疗晚期NSCLC的化疗疗效及不良反应进行分析比较。采用卡方检验分析其疗效和毒性。用Kaplan-Meier法估计生存率。

结果

三组的客观缓解率(ORR)分别为42.5%、43.1%和35.2%(P = 0.612)。疾病控制率(DCR)分别为84.1%、75.0%和74.1%(P = 0.198)。中位无进展生存期分别为5.6、5.8和3.2个月(P = 0.000)。主要不良反应为骨髓抑制、胃肠道反应、脱发和神经毒性等。三组神经毒性发生率分别为34.5%(39/113)、11.1%(8/72)和18.5%(10/54)(P = 0.001)。除神经毒性外,不良反应组间差异无统计学意义(均P > 0.05)。

结论

三种铂类联合化疗方案疗效良好,不良反应可接受。其ORR和DCR相似。紫杉醇组和吉西他滨组的中位无进展生存期明显长于多西他赛组。

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