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吉西他滨联合顺铂一线治疗晚期NSCLC的疗效及相关因素分析

Curative Analysis of Gemcitabine Plus Cisplatin for First Line Treatment of Advanced Non-small Cell Lung Cancer

  • 摘要: 目的评价吉西他滨联合顺铂一线治疗晚期非小细胞肺癌(NSCLC)的疗效,并探讨影响化疗疗效及预后的相关因素。方法回顾性分析113例至少接受2周期吉西他滨联合顺铂方案(GP方案)化疗的ⅢB~Ⅳ期NSCLC患者,评价疗效及不良反应;Kaplan-Meier法分析生存情况,Cox回归法进行多因素预后分析。结果GP方案的总有效率43.8%,临床特点未能预测疗效;中位无进展生存时间6.7月,中位生存时间16.7月。主要不良反应为1~2级骨髓抑制和胃肠道反应;多因素分析示吸烟状况、远处器官转移数目、肝脏转移、化疗周期数是影响预后的独立因素。结论GP方案治疗晚期NSCLC具有较高的疗效,不良反应低。吸烟、远处器官转移数目1个以上、肝脏转移是晚期NSCLC预后不良的因素;GP方案化疗4~6个周期能明显改善预后。

     

    Abstract: ObjectiveTo evaluate the curative effect and toxicities of gemcitabine plus cisplatin to therapy patients with advanced non-small cell lung cancer and identify factors to predict prognosis. Methods113 patients staged IIIB~IV NSCLC were received gemcitabine plus cisplatin as first line treatment. Response rates and toxicities were evaluated in patients who completed at least two cycles of chemotherapy. Progression free survival(PFS) and Overall survival(OS) were estimated using the Kaplan-Meier estimator. Cox regression analysis was used to identfy potential prognosis factors. ResultsThe overall response rate was 43.8%, and the baseline characteristics could not predict the efficacy. The median PFS and OS were 6.7 months and 16.7 months respectively. The predominant toxicities were grade 1 or 2 hematologic toxicities and gastrointestinal reaction. Multivariate analysis revealed that smoking status, numbers of metastasis, liver metastasis and chemotherapy cycles were independent prognosis factors. ConclusionGemcitabine plus cisplatin showed significant efficacy with less toxicities as first line treatment for advanced NSCLC. Smoking, liver metastasis and more than one metastatic sites were poor prognostic factors. Four to six cycles of chemotherapy were the optimal selection.

     

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