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Objective:To compare the efficacy and toxicity between gemdtabine plus cisplatin and plus carboplatin in firstline treatment of advanced non-small call lung cancer (NSCLC).Methods:Gemcitabine 1000 mg/m2 iv,d1,8;cisplatin 75 mg/m2 iv,d1,or 25 mg/m2 iv,d1-3;carboplatin AUC = 5 iv,d1;repeated every 21 days.Results:All 76 cases were available for objective response.Gemcitabine + cisplatin (GCis) group:among 33 cases,CR 1 case,PR 13 cases,MR 3 cases,SD 7 cases,PD 9 cases,response rate,disease control rate,time to progress (TTP),median survival time (MST) and 1-,2-year survival rates were 42.42% (14/33),72.73% (24/33),5 months,14 months and 66.67% (22/33),12.12% (4/33),respectively;Gemcitabine + carboplatin (GCarb) group:among 43 cases,PR 13 cases,MR 11 cases,SD 7 cases,PD 12 cases,the results while comparing with those of GCis group were 30.23% (13/43),72.09% (31/43),4 months,11 months and 48.84% (21/43),2.33% (1/43),respectively.Among them,only MST between the two groups had significant statistic difference (x2 = 2.45,P = 0.017).Mild to modest myelo-suppression as well as nausea and vomiting were observed.Conclusion:Both GCis and GCarb regimens had active and well-tolerated toxicity for advanced NSCLC.Cisplatin-based chemotherapy yields a substantial effective advantage over carboplatin-based regimens.Therefore,carboplatin and cisplatin are not equal-active and that cisplatin-based doublet regimens should remain the standard first-line therapy for patients with advanced NSCLC with good performance status.