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目的 评价MVP和TVP两种方案治疗晚期非小细胞肺癌的有效率、毒性和生存期。方法 66例晚期非小细胞肺癌随机分为两组 ,MVP组 3 2例 ,TVP组 3 4例 ,两组患者资料相似。MVP组 :丝裂霉素(MMC) 6～ 8mg/m2 ,静注 ,第 1天 ;长春花碱酰胺 (VDS) 2～ 3mg/m2 ,静滴 ,第 1、8天 ;顺铂 (DDP) 70～ 80mg/m2 ,静滴 ,第 1天或分两天。TVP组 :吡喃阿霉素 (THP) 40～ 5 0mg/m2 ,第 1天 ,VDS和DDP同上。两方案均为一周期 2 1天 ,每例完成 2～ 4周期。结果 MVP组有效率为 3 4% (完全缓解 1例 ,部分缓解 10例 ) ,TVP组有效率为 5 6% (完全缓解 1例 ,部分缓解 18例 ) ,TVP有效率高于MVP组 ,但统计学无意义 ( χ2 =2 .2 69,P=0 .13 2 )。TVP组Ⅲ +Ⅳ度骨髓抑制发生率高于MVP组 ,其中粒细胞抑制有显著性差异 ( 79%与 44 % ,χ2=7.45 8,P =0 .0 0 6)。MVP组与TVP组的中位生存期分别为 12个月与 8个月 ,1年生存率 5 3 %与 2 4% ( χ2=4.943 ,P =0 .0 2 6) ,2年生存率 17%与 6% ,3年生存率 6%与 0。结论 MVP有效率相对较低 ,但血液毒性低 ,患者生存期和生存率高 ,是晚期非小细胞肺癌化疗的合适方案。TVP方案近期有效率高 ,但血液毒性明显 ,与MVP方案比较 ,没有明显的生存受益
Objective To evaluate the efficacy, toxicity and survival of two regimens of MVP and TVP in the treatment of advanced non-small cell lung cancer. Methods Sixty-six patients with advanced non-small cell lung cancer were randomly divided into two groups: 32 patients in MVP group and 34 patients in TVP group. The data of two groups were similar. MVP group: MMC 6 ~ 8mg / m2, intravenous injection, the first day; vinblastine 2 ~ 3mg / m2, intravenous drip, 70 ~ 80mg / m2, intravenous infusion, the first day or two days. TVP group: pirarubicin (THP) 40 ~ 50mg / m2, the first day, VDS and DDP same as above. Two programs are a period of 21 days, each completed 2 to 4 cycles. Results The effective rate was 34% in MVP group (complete remission in 1 case, partial remission in 10 cases), TVP group was 56% (complete remission in 1 case, partial remission in 18 cases), TVP was more effective than MVP group Statistical significance (χ2 = 2.229, P = 0.132). The incidence of stage Ⅲ + Ⅳ myelosuppression in TVP group was higher than that in MVP group, and granulocyte inhibition was significantly different (79% vs 44%, χ2 = 7.45 8, P = 0.060). The median survival of MVP group and TVP group were 12 months and 8 months respectively, the 1-year survival rates were 53% and 24% (χ2 = 4.943, P = 0.026), and the 2-year survival rate was 17 % And 6%, 3-year survival rate 6% and 0. Conclusions MVP is relatively ineffective, but with low hematologic toxicity and high survival and survival rates. It is a suitable regimen for chemotherapy of advanced non-small cell lung cancer. TVP recent high efficiency, but the obvious hematotoxicity, compared with the MVP program, no significant survival benefit