摘要
目的探讨以吉西他滨为主联合化疗一线治疗晚期非小细胞肺癌(NSCLC)的疗效、疾病进展期(TTP)、生存期及毒副作用.方法126例经组织学或细胞学确诊的未曾治疗的晚期NSCLC,非随机接受GP/4周组(27例)、GP/3周组(65例)、GN组(34例).结果全组有效率(RR)35.7%(CR 1例,PR 45例),1年生存率35.6%(95%CI:CI.05～45.18),中位生存期(MST)10个月(95%CI:8～12),MTTP3.89个月(95%CI:3.67～7.30).GP/4周组RR 40.7%(CR 1例,RR 11例),一年生存率37.0%(95%CI:18.83～55.32),MST 8个月(95%CI:5～11),MTTP5.05个月(95%CI:3.48～8.95),中位缓解期(MRT)8.26个月(95%CI:8.13～20.32).GP/3周组RR为32.3%(PR:21例).1年生存率35.9%(95%CI:21.46～50.38),MST10个月(95%CI:8～12),MTTP 3.40个月(95%CI:2.73～4.02),MRT 1.51个月(95%CI:1.22～14.73).GN组RR38.2%(PR 13例),1年生存率31.0%(95%CI:13.10～48.96),MST 9个月(95%CI:6～12),MTT3.93个月(95%CI:2.02～8.08),MRT 2.16个月(95%CI:1.75～14.27).三组间RR、1年生存率、MS差异无显著性.MTTP GP/4周优于GP/3周组,有显著差异(P＜0.05),MRT GP/4周组优于其他两组有显著差异(P＜0.05).WHO血液学毒性,Ⅲ/Ⅳ度中性粒细胞下降,GP/4周组为14.29%,GP/3周组为8.38%,GN组为11.34%,3组间差异无显著性.Ⅲ/Ⅳ度贫血GP/4周组10.39%,GP/3周组1.22%,GN组3.96%.GP/4周组明显高于GP/3周组(P＜O.05),Ⅲ/Ⅳ度血小板减少GP/4周组26.32%,GP/3周组11.24%,GN组6.25%,GP/4周组明显高于其他两组(P＜0.05),非血液学毒性恶心/呕吐GN组明显优于GP/4周及GP/3周组(P＜0.05).结论GP/4周、GP/3周及GN显示相似的客观有效率,中位生存期及1年生存率,毒副作用显示GP/3周及GN较轻,为耐受性较好的治疗晚期NSCLC化疗方案.
Objective To evaluat and compare effecacy the gemcitabine-based three regimen(GP/4weeks,GP/3weeks,GN) for advanced non-Small cell lung cancer(NSCLC).Methods The 126 cases with non-threatment advance NSCLC were unrandomly divided into three groups,GP/4weeks(27 patients),GP/3weeks(65 patients) and GN(34 patients).Results For GP/4weeks groups,the overall response rate of this group was 40.7%(CR1,PR11),one year survival rate(1-ySR) was 37.0%(95%CI 18.83～55.32),MST was 8 months(95%CI 5～11),MTTP was 5.05 months,MRT was 8.26 months.For GP/3weeks group,there was no CR,PR was 32.3%,1-ySR was 35.9%(95%CI 21.46～50.38),MST was 10 months(95%CI 8～12),MTTP was 3.40 months,MRT was 1.51months.For GN groups,There was no CR,PR was 38.2%,1-ySR was 31.0%(95%CI 13.10～48.96),MST was 9 months(95% CI 6～12),MTTP was 3.93months,MRT 2.16 months.There were no significant difference in response rate,1-ySR and MST for these three groups(P>0.05).MTTP was significantly longer in GP/4weeks group than that in GP/3weeks and GN(P<0.05).MRT was also significantly longer in GP/4weeks group than the other two groups(P<0.05).WHO grade 3/4 neutropenia were similar in three groups(P>0.05).Grade 3/4 anemia occurred in 10.39% in GP/4weeks groups,and grade 3/4 aremia occurred in 1.22% in GP/3weeks groups,it was significantly highter in GP/4weeks groups than these in GP/3weeks groups(P<0.05).The grade 3/4 thrombocytopenia occured was also significantly higher in GP/4weeks(26.32%) than these in the other two groups(P<0.05).Nausea/vomiting of GN groups was significantly mild than the other groups(P<0.05).Conclusion There were no significant difference in the response rates,1-ySR,MST for the three groups.Toxicities were tolerable in GP/3week groups and GN,there fo GP/3week and GN might be better chemotherapeutic regiment for advanced NSCLC.
出处
《癌症进展》
2005年第6期596-601,共6页
Oncology Progress
