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1、澤菲聯(lián)合蓋諾治療不耐受順鉑晚期非小細胞肺癌臨床觀察福建醫(yī)科大學(xué)教學(xué)醫(yī)院福州肺科醫(yī)院腫瘤內(nèi)科陳群李育宏石琴謝強陳雨燕王成輝王琳摘要目的觀察并評價澤菲聯(lián)合蓋諾治療不能耐受順鉑的晚期非小細胞肺癌的療效和毒性。方法108例Ⅲ和Ⅳ期非小細胞肺癌既往均未曾放療或化療，按ECOG計分≤2，生存期超過三個月。WBC計數(shù)＞4.0×109/L，肝、腎功能生化指標正常，未有活動性感染征象。36例以澤菲聯(lián)合蓋諾（GN）為一線方案，另外36例以吉西他濱加順鉑（GP），36例以長春瑞濱加順鉑（NP）為一線方案作對照組。結(jié)果GP組、NP組和GN組RR%分別為44.4%、41.7%和36.1%，三組療效比較，x2=0.42
2、1，P=1.731，（P值＞0.05）無統(tǒng)計學(xué)差異性。三組的癥狀緩解率、全身體力狀況改善、TTP、一年生存率等亦無顯著性差異。GN組與另兩組在Ⅲ~Ⅳ度血液學(xué)毒性方面比較無統(tǒng)計學(xué)差異（P＞0.05）；GN組非血液學(xué)毒性比較少，生活質(zhì)量的影響較少，均有統(tǒng)計學(xué)差異性。結(jié)論GN方案療效較好，毒性較低，具有良好耐受的方案，尤其適合于不能耐受順鉑的晚期NSCLC患者。關(guān)鍵詞非小細胞肺癌；化學(xué)療法；吉西他濱；長春瑞濱；Gemcitabineplusvinorelbineinthetreatmentofadvancednon-smallcellcancerunendurablecisplatinum-bas
3、edchemotherapyCHENqun,LIyuhong,SIqing,XIEqiang,CHENyuyan,WANGchenhui,WANGlin.DepartmentofTomour,FuzhouPulmonaryHospital,Fuzhou350008,China.[Abstract]ObjectiveToevaluatetheefficacyandtoxicityofgemcitabineplusvinorelbineinthetreatmentofadvancednon-smallcellcancer(NSCLC)unendurablecisplatinum-basedche
4、motherapy.Methods108patientsofthestage3and4NSCLCwithECOGcounts≤2point,survivaltimemorethanthreemonths,countsofWBC＞4.0×109/L,functionofliverandkidneyarenormal,noinfectsymptom.allpatientstreatedpreviouslywithoutradiotherapyandchemotherapy,inthose36patientstreatedwithgemcitabineplusvinorelbine(GN),ano
5、ther36patientstreatedwithgemcitabinepluscisplatin(GP),and36patientsvinorelbinepluscisplatin.ResultsTheoverallresponserateswere44.4%inthegroupGP,41.7%inthegroupNPand36.1%inthegroupGN.NostatisticaldifferenceintheRRbetweenthreemethodsofchemotherapy,(x2=0.421,P=1.731,P＞0.05).AlsothatintheTimeToProgress
6、,LifeQuality,SymptomaticRespondandtheYearSurvivalRate.ToxicityofⅢ~ⅣdegreehaematologywereindistinguishablybetweenthegroupGNandtheanothertwogroups(P＞0.05).Toxicityofnon-haematologyofthegroupGNweremarked(P＜0.01＝.ConclusionThegroupGNhadthehigherefficacy,thattoxicitywaslower.Itiswelltolerancefortheadvan
7、cedNSCLC.ThegroupGNmaybefitforthespecialadvancedNSCLCunendurablecisplatinum-basedchemotherapy.[keywords]Non-smallcellcancer;Chemotherapy;Gemcitabine;VinorelbinelocatedintheTomb,DongShenJiabang,deferthenextd
