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目的观察国产吉西他滨联合铂类治疗晚期非小细胞肺癌(NSCLC)的临床疗效,不良反应及生活质量。方法晚期NSCLC患者随机分为两组:吉西他滨联合卡铂(GC方案组),吉西他滨联合顺铂(GP方案组)。GC组采用吉西他滨1000 mg/m2,静脉滴注30 min,d1、8,卡铂300 mg/m2,d1;GP组采用顺铂30 mg/m2,d1～3,吉西他滨用法同GC组。每3周为1个周期。治疗2个周期评价疗效,每个周期评价不良反应。采用EORTC QLQ-C30和QLQ-LC13问卷对患者治疗前、后症状和生活质量进行评价,并对结果进行比较分析。结果总有效率、中位生存时间、中位疾病进展时间(TTP)、1年生存率、临床获益率两组对比差异无统计学意义(均P>0.05);两组主要不良反应为骨髓抑制和恶心呕吐,其中GC组反应较轻;两组生活质量各领域包括功能子领域及症状子领域评分治疗后明显改善,GC组改善更明显。结论吉西他滨联合铂类治疗晚期NSCLC疗效确切,两组化疗方案均能明显改善患者生活质量。其中GC方案耐受性更好,不良反应轻,在改善患者生活质量方面有一定的优势。
Objective To observe the clinical efficacy, side effects and quality of life of domestic gemcitabine and platinum in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Patients with advanced NSCLC were randomly divided into two groups: gemcitabine plus carboplatin (GC regimen), gemcitabine plus cisplatin (GP regimen). The GC group was treated with gemcitabine 1000 mg / m2, intravenous infusion 30 min, d1,8, carboplatin 300 mg / m2, d1; cisplatin 30 mg / m2, d1-3 in GP group. Every 3 weeks for a period. Treatment 2 cycles evaluation of efficacy, adverse reactions each cycle evaluation. The EORTC QLQ-C30 and QLQ-LC13 questionnaires were used to evaluate the symptoms and quality of life of the patients before and after treatment, and the results were compared and analyzed. Results The total effective rate, median survival time, median time to progression of disease (TTP), 1-year survival rate and clinical benefit rate had no significant difference between the two groups (all P> 0.05). The main adverse reactions were bone marrow Inhibition and nausea and vomiting. The response of GC group was lighter. The quality of life improvement in both groups including functional sub-area and symptom sub-area was significantly improved after treatment, and the improvement in GC group was more obvious. Conclusion Gemcitabine combined with platinum is effective in treating advanced NSCLC. Both chemotherapy regimens can significantly improve the quality of life of patients. Among them, the GC regimen is better tolerated, with less adverse reactions, and has certain advantages in improving the quality of life of patients.