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目的 :较IM -EP方案与EP方案对初治Ⅲb～Ⅳ期非小细胞肺癌 (non smallcelllungcancer ,NSCLC)病人的疗效、毒性及生活质量的改善情况。方法 :A组 (33例 )接受IM -EP方案治疗 ;B组 (35例 )接受EP方案治疗。两组均以每 4周为一周期 ,重复 3个周期。客观疗效与毒性反应按WHO标准进行评价 ,生活质量根据临床受益疗效来评价。结果 :A、B两组客观疗效 (CR +PR)分别为 2 7 3%及 2 2 9% ,P >0 0 5 ;中位生存期A组 32周 ,B组 2 7周 (P <0 0 1) ;白细胞减少及恶心呕吐反应B组均较A组明显 (P <0 0 1) ;短暂性寒战、发热症状多见于A组 (P <0 0 1) ;两组均未发现其它严重的毒性反应。临床受益疗效A组高于B组 (P <0 0 5 )。结论 :干扰素α、甲地孕酮配合EP方案与单纯EP方案治疗晚期NSCLC的客观疗效无明显差异性 ,但前者毒副反应小 ,中位生存期长 ,病人生活质量改善明显。
OBJECTIVE: To compare the efficacy, toxicity and quality of life of patients with non-small cell lung cancer (NSCLC) who underwent stage IIIb-IV treatment with IM -EP and EP. Methods: Group A (33 cases) received IM -EP regimen; Group B (35 cases) received EP regimen. The two groups were every 4 weeks for a cycle, repeat 3 cycles. Objective efficacy and toxicity response to WHO standards for evaluation, quality of life based on clinical benefit evaluation. Results: The objective response (CR + PR) of group A and group B were respectively 27.3% and 29.2%, P> 0.05. The median survival time was 32 weeks in group A and 27 weeks in group B (P <0 0 1). The leukopenia and nausea and vomiting responses in group B were significantly higher than those in group A (P <0.01). The symptoms of transient shivering and fever were more common in group A than in group A (P <0.01) Toxicity. The clinical benefit of A group was higher than that of B group (P <0.05). Conclusion: There is no significant difference in the objective curative effect between interferon α, megestrol combined with EP and simple EP in the treatment of advanced NSCLC. However, the former has small toxic side effects, long median survival and significant improvement in patients’ quality of life.