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目的观察吉西他滨联合卡铂治疗晚期非小细胞肺癌(NSCLC)的疗效和毒副作用。方法经病理确诊的NSCLC40例,其中腺癌26例,鳞癌12例,大细胞癌1例,肺泡细胞癌1例。初治34例,复治6例;Ⅲ期14例,Ⅳ期26例。采用吉西他滨1000mg/m2,第1、8天静脉滴入;卡铂AUC=6,静脉滴入,第1天。常规给予止吐处理,21d为1个周期,治疗2个周期后进行疗效评价。结果全组完全缓解2例,部分缓解15例,稳定14例,进展9例。有效率为42.5%,临床收益率为77.5%,中位生存期为6.3个月,1年生存率为52.6%。主要血液性毒性为Ⅲ～Ⅳ级血小板下降(32.5%)。结论吉西他滨联合卡铂方案治疗晚期NSCLC疗效确切,血液毒性可以耐受,肾毒性及胃肠道等不良反应较少,患者依从性好,可作为晚期NSCLC患者的一线化疗方案。
Objective To observe the efficacy and side effects of gemcitabine and carboplatin in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Forty NSCLC patients were pathologically diagnosed, including 26 cases of adenocarcinoma, 12 cases of squamous cell carcinoma, 1 case of large cell carcinoma and 1 case of alveolar cell carcinoma. The initial treatment in 34 cases, 6 cases of retreatment; Ⅲ in 14 cases, Ⅳ in 26 cases. Gemcitabine 1000mg / m2, intravenous infusion on day 1,8; carboplatin AUC = 6, intravenous infusion, the first day. Routinely given antiemetic treatment, 21d for a cycle of treatment for 2 cycles after the efficacy evaluation. Results The whole group was completely relieved in 2 cases, partly in 15 cases, stable in 14 cases and 9 cases in progress. The effective rate was 42.5%, the clinical rate of return was 77.5%, the median survival time was 6.3 months, and the 1-year survival rate was 52.6%. The main hematologic toxicity was grade Ⅲ ~ Ⅳ thrombocytopenia (32.5%). Conclusion The combination of gemcitabine and carboplatin is effective in the treatment of advanced NSCLC. Hematotoxicity is tolerable. Nephrotoxicity and gastrointestinal tract are less adverse reactions. Gefitinib combined with carboplatin is a good first-line chemotherapy for patients with advanced NSCLC.