国产紫杉醇联合顺铂治疗晚期非小细胞肺癌40例疗效观察
Combination chemotherapy of domestic paclitaxel plus cisplatin in treatment of advanced non-small cell lung cancer
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摘要: 目的: 观察国产紫杉醇联合顺铂治疗Ⅲ~Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的近期疗效、毒副反应及恶性肿瘤相关物质(tumor supplied group of factors,TSGF)的变化。方法: 初治的Ⅲ~Ⅳ期NSCLC患者40例,以国产紫杉醇135 mg/m2,静脉滴注,d1,顺铂30 mg/m2,静脉滴注,d1~d3,连用2个周期后评价疗效,TSGF应用生化比色法检测。结果: 全组35例可评价,部分缓解(PR)15例,稳定(SD)12例,进展(PD)8例,有效率(CR+PR)为42.9%。主要毒副反应为胃肠反应(Ⅲ~Ⅳ级为11.4%)和血液学毒性(Ⅲ~Ⅳ级白细胞下降为14.2%)。在治疗有效的患者中治疗后TSGF明显下降(P<0.001),而在治疗无效的患者中治疗后TSGF无明显下降(P>0.05)。结论: 国产紫杉醇联合顺铂治疗NSCLC有较好疗效,毒性较小,TSGF可作为肺癌治疗疗效的评价依据之一。Abstract: Objective: To evaluate the efficacy and toxicity reactions of domestic paclitaxel plus cisplatin in the treatment of advanced non-small cell lung cancer(NSCLC).Methods: Forty previously untreated patients with advanced NSCLC were selected and domestic paclitaxel was given at a dose of 135 mg/m2 on day 1 and cisplatin at a dose of 30 mg/m2 on day 1 to 3.The chemotherapy was repeated every 21 days with two cycles.Tumor supplied group of factors(TSGF) was measured by biochemical method.Results: The overall response rate was 42.9%.The main maintoxicity reactions were nausea/vomiting(11.4% were in gradeⅢ to Ⅳ) and hematologic toxicity(the prevalence of grade Ⅲ to Ⅳ leukopenia decreased to 14.2%).The serum level of TSGF decreased significantly(P<0.001)in the response patients after two cycles of chemotherapy but the change of serum level of TSGF was not obvious in the non-response patients.Conclusions: The combination therapy of paclitaxel plus cisplatin is a highly effective regimen for patients with advanced NSCLC with a manageable toxicity.