GP 方案与NP 方案治疗晚期非小细胞 肺癌的疗效比较
Comparison of GP and NP Regimen in Treatment of Advanced Non2small Cell Lung Cancer
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摘要: 目的 观察吉西他滨联合顺铂( GP 方案) 与长春瑞滨联合顺铂(NP 方案) 治疗晚期非小细胞肺癌(NSCLC) 的疗效、生存率及毒副反应。方法 对80 例经病理或细胞学证实的晚期非小细胞肺癌患者给予联合化疗,GP 方案41 例,NP 方案39 例,两组病例具有可比性。吉西他滨1 000 mg/ m2, 静脉滴注第1 、8 天,顺铂30 mg/ m2, 静脉滴注第1～3 天,长春瑞滨25 mg/ m2, 静脉滴注第1 、8 天,21 天为一个周期,每例患者治疗2 周期以上。结果 GP 组总有效率41. 5 %, 1 年生存率36. 6 %, 中位生存期9. 4月;NP 组总有效率38. 5 %, 1 年生存率35. 9 %, 中位生存期8. 9月。两组间有效率、1 年生存率比较差异无统计学意义( P > 0. 05) 。最常见的毒副反应为骨髓抑制,GP 组Ⅲ～ Ⅳ度血小板减少发生率显著高于NP 组 ( P < 0. 05), 而NP 组Ⅲ～ Ⅳ度白细胞减少发生率显著高于GP 组( P < 0. 05) 。结论 GP 方案与NP 方案治疗晚期非小细胞肺癌(NSCLC), 疗效肯定,毒性均可耐受。两方案疗效无显著差异。Abstract: Objective To evaluate and compare the efficacy and toxicity between combination of gemcit2 abine and cisplatin ( GP) and combination of navelbine and cisplatin (NP) in the t reatment of patient s with advanced non - small cell lung cancer (NSCLC) . Methods Eighty patient s with locally advanced or me2 tastatic NSCLC were enrolled into the study, with 41 patient s in GP group and 39 in NP group . Patient s ' characteristics were similar between the two groups. They were given gemcitabine 1 000 mg/ m2, or na2 velbine 25 mg/ m2 on days 1 and 8, and cisplatin 30 mg/ m2 on days 1～3. The chemotherapy was repeat2 ed every 3 weeks as a cycle. Results An objective response rate of 41. 5 % was observed in GP arm ver2 sus 38. 5 % in NP arm ( P > 0. 05) . The 12year survival rate was 36. 6 % in GP compared to 35. 9 % in NP ( P > 0. 05) . The median survival duration was 9. 4 months for GP arm and 8. 9 months for NP arm. My2 elosuppression was the major dose2limiting toxicity. The incidence of grade Ⅲ/ Ⅳleukopenia was signifi2 cantly higher in the NP group than that in GP group ( P < 0. 05), while grade Ⅲ/ Ⅳ thrombocytopenia occurred more f requently in the GP group than that in NP group ( P < 0. 05) . Conclusion The GP combi2 nation is as equally active and well tolerated as the NP combination in the t reatment of patient s with ad2 vanced NSCLC.
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