奈达铂联合多西他赛治疗晚期非小细胞肺癌的临床疗效观察

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【目的】观察比较奈达铂联合多西他赛化疗方案与顺铂联合多西他赛化疗方案治疗晚期非小细胞肺癌(NSCLC )的近期疗效及不良反应。【方法】本院70例晚期NSCLC患者根据使用化疗药物不同分为两组,分别为奈达铂联合多西他赛治疗36例,顺铂联合多西他赛治疗34例。具体用药方案为奈达铂组:采用奈达铂25 mg/(m2· d),d1~3给予,多西他赛75 mg/m2,d1。顺铂组:采用顺铂25 mg/(m2· d),d1~3给予,21 d为1个周期,化疗2个周期后按WHO标准评价疗效及不良反应。【结果】奈达铂组:完全缓解(CR)1例,部分缓解(PR)14例,稳定(SD)18例,进展(PD)3例,有效率(RR)为41.7%(15/36);顺铂组:CR 1例,PR 13例,SD 18例,PD 2例,有效率(RR)41.2%(14/34),两组有效率比较差异无显著性( P >0.05)。消化道反应:奈达铂组和顺铂组分别为5.6%(2/36)和29.4%(10/34),两组相比较差异有显著性( P <0.01);肾毒性分别为0(0/36)和5.9%(2/34)( P <0.05);骨髓抑制:白细胞减少奈达铂组为72.2%(26/36),顺铂组为70.6%(24/34),两组相比较差异无显著性( P>0.05)。【结论】奈达铂联合多西他赛方案治疗晚期NSCLC的有效率不低于顺铂联合多西他赛方案,胃肠道毒性较顺铂联合多西他赛组轻,不良反应主要为骨髓抑制,两组白细胞下降无差异,但血小板下降较顺铂联合多西他赛组明显。“,”Objective To observe and compare the short-term efficacy and adverse reaction of nedaplatin and docetaxel combination chemotherapy regimen vs .cisplatin and docetaxel combination chemotherapy regimen for the treatment of patients with advanced non-small cell lung cancer(NSCLC) .[Methods] According to chemotherapeutics ,70 patients with NSCLC in our hospital were divided into nedaplatin combined with docetaxel group ( n=36) and cisplatin combined with docetaxel group ( n=34) .Nedaplatin group was given nedaplatin 25 mg/(m2 · d) at d1 ~d3 and docetaxel 75mg/m2 at d1 .Cisplatin group was given cisplatin 25 mg/(m2 · d) at d1 ~d3 .The course was 21 days .After 2 cycles of chemotherapy ,the efficacy and adverse reaction were evaluated by WHO standard .[Results] In nedaplatin group ,1 patient was complete remission(CR) ,and 14 pa-tients were partial remission(PR) ,and 18 patients were stable(SD) ,and 3 patients were progression(PD) ,and the effective rate(RR) was 41 .7% (15/36) .In cisplatin group ,there were CR in 1 patient ,PR in 13 patients ,SD in 18 patients and PD in 2 patients ,and the RR was 41 .2% (14 /34) .There was no significant difference in effective rate between two groups ( P >0 . 05) .The rate of gastrointestinal tract reaction in nedaplatin group and cisplatin group was 5 .6% (2/36) and 29 .4% (10/34) re-spectively ,and there was significant difference between two groups( P<0 .01) .The rate of renal toxicity in nedaplatin group and cisplatin group was 0% (0/36) and 5 .9% (2/34) respectively ( P 0 .05) .[Conclusion] The effective rate of nedaplatin combined with docetaxel regimen for the treatment of NSCLC is not lower than that of cisplatin combined with docetaxel regimen .The gastrointestinal toxicity of nedaplatin combined with docetaxel reg-imen is less than that of cisplatin combined with docetaxel regimen .The main adverse reaction is bone marrow suppression . There is no difference in leucopenia between two regimens .The decreasing of platelet in nedaplatin combined with docetaxel regimen is more obvious than that in cisplatin combined with docetaxel regimen .
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