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目的 :对比NP和MVP两组方案治疗晚期非小细胞肺癌的疗效和毒性。方法 :通过NP和MVP两个联合化学治疗方案每 2 1～ 2 8天周期全身给药的方法共收治晚期非小细胞肺癌 2 46例 ,其中腺癌 15 9例 ,鳞癌 5 5例 ,其他 32例。初治 177例 ,复治 6 9例。结果 :NP组和MVP组有效率分别为 35 7% (35 / 98)和 34 5 % (5 1/ 148) ,两组无显著性差异 (P >0 0 5 )。中位缓解期NP组为 5个月 ,MVP组为 4个月 ;中位生存期NP组为 11个月 ,MVP组为 8个月 ,均无显著性差异。毒副作用主要是骨髓抑制。Ⅲ～Ⅳ度白细胞下降率NP组为 5 0 0 % ,MVP组为 38 5 % ,两组间有显著差异 (P <0 0 5 ) ,Ⅲ～Ⅳ度血小板下降率NP组为 4 1% ,MVP组为 7 4% (P >0 0 5 )。Ⅲ～Ⅳ度消化道反应两组发生率分别为 15 3%和 18 2 %且以Ⅲ度为主。结论 :NP和MVP两方案治疗晚期非小细胞肺癌有效率较高且相似 ,中位生存期虽无明显差异但NP方案较长。白细胞下降的副反应虽有差异性但均可耐受。因此 ,从不同的需要和考虑出发 ,两者均可作为治疗晚期非小细胞肺癌的首选方案。
Objective: To compare the efficacy and toxicity of NP and MVP regimens in the treatment of advanced non-small cell lung cancer. METHODS: Two-hundred and sixty-six patients with advanced non-small-cell lung cancer were treated by systemic administration of NP and MVP two-to-one-eight-day cycles, including 149 adenocarcinomas, 55 squamous cell carcinomas, and others. 32 cases. 177 cases were initially treated and 69 cases were retreated. Results: The effective rates of NP and MVP groups were 35 7% (35 / 98) and 34 5% (5 1 / 148) respectively. There was no significant difference between the two groups (P > 0.05). The median remission period was 5 months in the NP group and 4 months in the MVP group; the median survival period was 11 months in the NP group and 8 months in the MVP group, with no significant difference. The toxic side effects are mainly myelosuppression. The rate of white blood cell decline in III to IV degree was 500% in the NP group and 38.5 % in the MVP group. There was a significant difference between the two groups (P < 0.05). The platelet reduction rate in the III to IV degree group was 41% in the NP group. The MVP group was 7 4% (P > 0 0 5 ). The incidence of III-IV digestive tract reactions in the two groups was 153% and 18%, respectively, and mainly in III degree. Conclusion : Both NP and MVP regimens are effective and similar in the treatment of advanced non-small cell lung cancer. Although the median survival period is not significantly different, the NP regimen is longer. Although the adverse reactions of leukocyte decline are different, they can be tolerated. Therefore, starting from different needs and considerations, both can be used as the first choice for the treatment of advanced non-small cell lung cancer.