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背景与目的:非小细胞肺癌(non-smallcelllungcancer,NSCLC)对常用的一、二线化疗方案敏感性较低,在化疗中联用喜树碱类衍生物已引起国内外的研究兴趣。本研究旨在观察羟基喜树碱(hydroxycamptothecin,HCPT)联合丝裂霉素(mitomycin,MMC)、长春花碱酰胺(vindesine,VDS)和顺铂(cisplatin,DDP)组成的HMVP、MVP和HVP方案治疗晚期NSCLC的近期、远期疗效和不良反应。方法:134例晚期NSCLC患者随机分为HMVP组(46例)、MVP组(44例)和HVP组(44例),接受相应方案的化疗,观察各组的近期及远期疗效、不良反应和生存情况。结果:HMVP、MVP和HVP三组的有效率分别为39.54%、36.59%和26.19%,三组之间无显著性差异(P>0.05);三组的中位缓解期、中位生存期、1年及2年生存率亦无明显差别。三组之间的Ⅲ～Ⅳ度白细胞减少、Ⅲ～Ⅳ度血小板减少、Ⅲ～Ⅳ度恶心/呕吐及Ⅲ～Ⅳ度便秘发生率均无显著性差异(P>0.05)。结论:MVP方案治疗晚期NSCLC的疗效略低于HMVP方案,但后者未显示出明显的疗效优势,且可能增加白细胞抑制、恶心/呕吐和便秘的发生率。MVP方案疗效略高于HVP方案。
BACKGROUND & AIM: Non-small cell lung cancer (NSCLC) is less sensitive to the first- and second-line chemotherapy regimens commonly used. Chemotherapy with camptothecin derivatives has attracted research interests both at home and abroad. This study aimed to observe the effects of HCPT combined with mitomycin (MMC), vindesine (VDS) and cisplatin (DDP) on HMVP, MVP and HVP Short-term, long-term effects and adverse reactions in the treatment of advanced NSCLC. Methods: One hundred and thirty-four patients with advanced NSCLC were randomly divided into HMVP group (46 cases), MVP group (44 cases) and HVP group (44 cases). The patients received NSCLC were treated with the corresponding regimens. The short-term and long- Survival. Results: The effective rates of HMVP, MVP and HVP in the three groups were 39.54%, 36.59% and 26.19% respectively. There was no significant difference between the three groups (P> 0.05). The median remission, median survival, There was no significant difference in 1-year and 2-year survival rates. There was no significant difference in the incidence of Ⅲ ~ Ⅳ leukopenia, Ⅲ ~ Ⅳ thrombocytopenia, grade Ⅲ ~ Ⅳ nausea / vomiting and Ⅲ ~ Ⅳ degree constipation between the three groups (P> 0.05). Conclusions: The efficacy of MVP in the treatment of advanced NSCLC is slightly lower than that of the HMVP regimen, but the latter does not show a significant therapeutic advantage and may increase the incidence of leukopenia, nausea / vomiting and constipation. MVP program slightly higher efficacy than the HVP program.