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目的比较国产异环磷酰胺(IFO)联合奈达铂(NDP)与单药多西他赛(TXT)二线治疗晚期肺鳞癌的疗效、毒副反应及预后。方法回顾性分析我院接受二线化疗的77例晚期肺鳞癌患者的临床资料,37例接受IFO联合NDP治疗(联合组),40例接受单药TXT治疗(单药组)。具体用药如下:IFO 1.3g/m2,d1～d3;NDP 80～100mg/m2,d1;TXT 75mg/m2,d1。均21天为1周期,2周期评价疗效和毒副反应。结果联合组客观有效率(RR)为40.5%,单药组RR为17.5%,两组差异具有统计学意义(P<0.05);联合组疾病控制率(DCR)为86.5%,单药组DCR为75.0%。联合组1年生存率为32.1%,中位总生存期(OS)为10.0个月,单药组1年生存率为29.2%,中位OS为9.0个月,两组差异无统计学意义(P>0.05);联合组中位无进展生存期(PFS)为18.0周,单药组中位PFS为13.0周,两组差异有统计学意义(P<0.05)。联合组的毒副反应包括白细胞减少、血小板减少及恶心、呕吐,发生率均明显高于单药组。经Cox多元回归分析,治疗前PS评分、肿瘤分期及二线治疗获益情况均为影响患者生存的独立预后因素。结论 IFO联合NDP方案较单药TXT二线治疗晚期肺鳞癌患者未显著增加患者的OS,但近期有效率更高,并能延长患者的PFS;血液学及消化道毒副反应更明显,但可耐受。
Objective To compare the efficacy, toxicity, and prognosis of advanced squamous cell carcinoma of the lungs treated with ifosfamide (IFO) combined with nedaplatin (NDP) and monotherapy docetaxel (TXT). Methods The clinical data of 77 patients with advanced squamous cell carcinoma of lung admitted to second-line chemotherapy in our hospital were analyzed retrospectively. 37 patients received IFO combined with NDP (combination group) and 40 patients received single-agent TXT (single agent group). Specific drugs are as follows: IFO 1.3g / m2, d1 ~ d3; NDP 80 ~ 100mg / m2, d1; TXT 75mg / m2, d1. 21 days for a cycle, 2 cycles evaluation of efficacy and side effects. Results The objective effective rate (RR) was 40.5% in combined group and 17.5% in single drug group (P <0.05). The combined control group had a disease control rate (DCR) of 86.5% 75.0%. The 1-year survival rate was 32.1% in the combined group, and the median overall survival (OS) was 10.0 months. The 1-year survival rate in the single drug group was 29.2% and the median OS was 9.0 months. There was no significant difference between the two groups P> 0.05). The median progression-free survival (PFS) was 18.0 weeks in the combination group and 13.0 weeks in the single drug group. There was significant difference between the two groups (P <0.05). The combined group of toxic side effects include leukopenia, thrombocytopenia and nausea, vomiting, the incidence was significantly higher than the single drug group. Cox multivariate regression analysis, PS score before treatment, tumor staging and second-line benefit of treatment are independent prognostic factors affecting the survival of patients. CONCLUSION: IFO combined with NDP regimen is superior to single-agent TXT second-line treatment for patients with advanced squamous cell carcinoma of the lung without significant increase of OS, but more effective in the near future and prolongation of PFS in patients with advanced lung squamous cell carcinoma. Hematology and gastrointestinal toxicity are more obvious Tolerance.