摘要
目的比较4种一线含铂两药联合方案治疗晚期非小细胞肺癌(NSCLC)的疗效,并探讨进一步改善患者预后的可能途径。方法回顾性分析358例Ⅲ/Ⅳ期非小细胞肺癌接受第三代含铂两药联合方案化疗并随访,Kap-lan-Meier法生存分析和COX回归分析。结果 358例患者中初治病例311例,可评价疗效者228例,其中NP/NC组有效率为35.3%,疾病控制率为72.9%;GP/GC组有效率为36.8%,疾病控制率为71.3%;TP/TC组有效率为37.0%,疾病控制率为70.4%;DP/DC组有效率为34.5%,疾病控制率为79.3%。各组有效率及疾病控制率比较差异均无统计学意义(P>0.05)。47例复治病例有效率为21.3%;疾病控制率为72.4%,有效率低于初治组。Kaplan-Meier法统计分析NP/NC、GP/GC、TP/TC、DP/DC、复治组一年生存率分别为51.5%、52.3%、42.9%、55.0%、37.5%,复治组一年生存率低于初治病例(P<0.05)。一线化疗后疗效评价为CR及PR者预后明显优于PD者。COX模型回归分析显示:治疗前KPS评分、临床分期、一线化疗后疗效评价具有独立的预后意义(P<0.05),而性别、年龄、病理分型、有无合并症、体质量下降、大量吸烟史等均未显示出独立的预后意义。结论 4种一线含铂两药联合方案治疗晚期NSCLC的疗效无明显差异。治疗前KPS评分、临床分期、一线化疗后疗效评价对于晚期NSCLC有独立预后意义。
Objective To compare the effects of two-drug combined chemotherapy protocols from 4 kinds of first line drugs with platonic element in the treatment of advanced non-small cell lung cancer（NSCLC）,and further explore the possible ways to improve the patients＇ prognosis.Methods The data of 358 patients with advanced NSCLC of Ⅲ/Ⅳ stages,who received the third generation platinum based chemotherapy protocols of two-drug combination and were followed up,were retrospectively analyzed,Kaplan-Meier and COX regression were used.Results Of the 358 patients,311 were initially-treated cases and 228 can be evaluated.The overall response rate（RR） in the group NP/NC,GP/GC,TP/TC,DP/DC were 35.3%,36.8%,37.0%,34.5% respectively;the disease control rate（DCR） in the four group were 72.9%,71.3%,70.4%,79.3% respectively,with no significant differences in RR and DCR among the four groups （P0.05）.Of the 47 re-treated patients,the RR was 21.3% being lower than that of the initial treatment group （P0.05）,and DCR was 72.4%.The survival analysis in Kaplan-Meier showed one year-survival rates of NP/NC,GP/GC,TP/TC,DP/DC and re-treatment groups were 51.5%,52.3%,42.9%,55.0%,37.5% respectively.One year-survival rate of re-treatment group was lower than that of initial treatment group （P0.05）.The survival curve was better in patients whose evaluation was CR or PR after first-line chemotherapy than in those whose evaluation was PD.COX model regression analysis showed that KPS score,clinical stages,therapeutic effect after first-line chemotherapy can display their independent prognostic significance （P0.05）,but sex,age,pathology types,complication,weight loss,and smoking cannot.Conclusion The efficacy of the third generation platinum based chemotherapy protocols in the treatment of NSCLC does not show any statistical difference.The KPS score before treatment,clinical stages,and effect after first-line chemotherapy are of independent prognostic significance.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第30期3378-3380,共3页
Chinese General Practice
关键词
癌
非小细胞肺
抗肿瘤联合化疗方案
临床分析
Carcinoma
non-small cell lung
Antineoplastic combined chemotherapy protocols
Clinical analysis
