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1、泽菲联合盖诺治疗不耐受顺铂晚期非小细胞肺癌临床观察福建医科大学教学医院福州肺科医院肿瘤内科陈群李育宏石琴谢强陈雨燕王成辉王琳摘要目的观察并评价泽菲联合盖诺治疗不能耐受顺铂的晚期非小细胞肺癌的疗效和毒性。方法108例Ⅲ和Ⅳ期非小细胞肺癌既往均未曾放疗或化疗，按ECOG计分≤2，生存期超过三个月。WBC计数＞4.0×109/L，肝、肾功能生化指标正常，未有活动性感染征象。36例以泽菲联合盖诺（GN）为一线方案，另外36例以吉西他滨加顺铂（GP），36例以长春瑞滨加顺铂（NP）为一线方案作对照组。结果GP组、NP组和GN组RR%分别为44.4%、41.7%和36.1%，三组疗效比较，x2=0.42
2、1，P=1.731，（P值＞0.05）无统计学差异性。三组的症状缓解率、全身体力状况改善、TTP、一年生存率等亦无显著性差异。GN组与另两组在Ⅲ~Ⅳ度血液学毒性方面比较无统计学差异（P＞0.05）；GN组非血液学毒性比较少，生活质量的影响较少，均有统计学差异性。结论GN方案疗效较好，毒性较低，具有良好耐受的方案，尤其适合于不能耐受顺铂的晚期NSCLC患者。关键词非小细胞肺癌；化学疗法；吉西他滨；长春瑞滨；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
