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目的观察比较奈达铂与顺铂分别联合吉西他滨治疗晚期肺鳞癌的疗效和不良反应发生情况。方法选取医院收治的晚期肺鳞癌患者118例,随机分为吉西他滨联合奈达铂组(59例)和吉西他滨联合顺铂组(59例),比较2组患者治疗效果(包括:CR:完全缓解;PR:部分缓解;SD:疾病稳定;PD:疾病进展;ORR:客观有效率;DCR:疾病控制率)、生存率、无进展生存期和不良反应发生情况。结果 2组患者PR、SD、PD、ORR和DCR分别进行统计学比较,差异均无统计学意义(P>0.05)。2组患者无进展生存期(PFS)比较差异无统计学意义(P>0.05)。吉西他滨+顺铂组不良反应中白细胞减少、中性粒细胞减少、贫血、心电图异常、脱发的发生率均高于吉西他滨+奈达铂组(P<0.01或P<0.05);吉西他滨+奈达铂组与吉西他滨+顺铂组相比在血小板减少明显(P<0.01)。吉西他滨+奈达铂组中发生Ⅲ~Ⅳ度不良反应事件共6例(10.17%),顺铂组中共14例(23.73%),差异有统计学意义(P<0.05)。生活质量方面比较,吉西他滨+奈达铂组改善率高于吉西他滨+顺铂组(P<0.01);在稳定率方面、在下降率方面,2组差异无统计学意义(P>0.05)。结论吉西他滨联合奈达铂可作为晚期肺鳞癌一线治疗的优选方案之一。
Objective To compare the efficacy and side effects of nedaplatin and cisplatin combined with gemcitabine in the treatment of advanced squamous cell carcinoma of the lung. Methods A total of 118 advanced squamous cell carcinoma patients admitted to hospital were randomly divided into gemcitabine combined with nedaplatin group (59 cases) and gemcitabine plus cisplatin group (59 cases). The therapeutic effects of two groups were compared (including CR: complete remission ; PR: partial remission; SD: stable disease; PD: disease progression; ORR: objective efficiency; DCR: disease control rate), survival, progression-free survival and adverse events. Results There was no significant difference in PR, SD, PD, ORR and DCR between the two groups (P> 0.05). There was no significant difference in progression-free survival (PFS) between the two groups (P> 0.05). The rates of leukopenia, neutropenia, anemia, electrocardiogram abnormalities and hair loss in gemcitabine + cisplatin group were significantly higher than those in gemcitabine + nedaplatin group (P <0.01 or P <0.05). Gemcitabine + Compared with gemcitabine + cisplatin group, the thrombocytopenia was significantly reduced (P <0.01). There were 6 cases (10.17%) of Ⅲ ~ Ⅳ adverse reactions occurred in gemcitabine + nedaplatin group and 14 cases (23.73%) in cisplatin group, the difference was statistically significant (P <0.05). The quality of life of gemcitabine + nedaplatin group was higher than that of gemcitabine + cisplatin group (P <0.01). There was no significant difference between the two groups in the stability rate (P> 0.05). Conclusion Gemcitabine combined with nedaplatin can be used as one of the preferred options for first-line treatment of advanced squamous cell carcinoma of the lung.