吉西他滨联合长春瑞滨治疗铂类耐药中晚期非小细胞肺癌23例

    Clinical observation on gemcitabine associated with navelbine in the treatment of 23 cases with advanced non-small cell lung cancer resistant to platinum

    • 摘要: 目的:评价吉西他滨(GEM)与长春瑞滨(NVB)联合(GN方案)治疗对铂类方案耐药的中晚期非小细胞肺癌(non-smallcell lung cancer,NSCLC)的疗效及毒副反应。方法:23例既往接受铂类治疗2周期以上无效的中晚期NSCLC患者,改为GN方案治疗。具体为吉西他滨1000mg/m2静脉滴注d1、d8;长春瑞滨25mg/m2静脉滴注d1、d8结果:23例对铂类耐药的中晚期NSCLC患者经本方案治疗后,总有效率39.1%,中位生存期9.8个月,疾病进展时间为5.7个月,1年生存率45.8%,主要不良反应是血液学毒性,表现为Ⅰ~Ⅱ度白细胞减少78.3%,Ⅲ~Ⅳ度白细胞减少13.0%,Ⅰ~Ⅱ度血小板减少和红细胞减少分别为43.5%和30.4%;非血液学毒性包括Ⅰ~Ⅱ度的恶心、呕吐、局部静脉炎等。结论:GN方案对铂类方案耐药的中晚期NSCLC疗效较好,毒副反应可以耐受,值得在临床上推广和应用。

       

      Abstract: Objective: To value the the efficacy and toxicities of gemcitabine(GEM) associated with navelbine(NVB) (GN protocol) on treatment of patients with advanced non-small cell lung cancer(NSCLC) resistant to platinum.Methods: Twenty-three cases of NSCLC anciently treated with platinum for two cycles with no obvious therapeutic effect were treated with GN.The details on the therapy are as follows:GEM was taken through the intravenous dripping at 1 000 mg/m2 on the day 1st and day 8th while NVB was taken through the intravenous dripping at 25 mg/m2 on the day 1st and day 8th.Results: These patients who were treated with GN were acquired 39.1% of the total effective rate,9.8 months of the median survival time,5.7 months of the illness advancing time and 45.8% of one-year survival rate.The major toxicity lies with the hematology,it is manifested by 78.3% of the decrease on the white cellⅠ~Ⅱ,13.0% of the decrease on the white cell Ⅲ~Ⅳ,43.5% of theⅠ~Ⅱ decrease on the platelet and 30.4% of anemia.The toxicity in the non-hematology includes vomiting,nausea and local phlebitis and so on.Conclusions: GN protocol with GEM associated with NVB has a superior therapeutic effect on advanced NSCLC resistant to Platinum with endurable side effects,which is worth popularizing and applying in the clinic.

       

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