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目的本研究旨在观察初治的晚期非小细胞肺癌患者接受吉西他滨加顺铂(GCis)和吉西他滨加卡铂(GCarb)是否具有相同的治疗效果,卡铂能否完全替代顺铂,从而成为晚期非小细胞肺癌患者化疗的标准含铂二药联合方案。方法吉西他滨1 000 mg/m2,静脉滴注,d1,8;顺铂75 mg/m2,d1或25 mg/m2,d1-3;卡铂AUC=5;每21 d为1周期,分别化疗3~6周期。结果入组76例均可评价疗效,GCis组:33例中,CR 1例,PR 13例,MR 3例,SD 7例,PD 9例,有效率42.42%(14/33);疾病控制率72.73%(24/33);中位TTP 5个月;中位生存期14个月;1年生存率66.67%(22/33);2年生存率12.12%(4/33)。GCarb组:43例中,PR 13例,MR11例,SD 7例,PD 12例,有效率30.23%(13/43);疾病控制率72.09%(31/43);中位TTP 4个月;中位生存期11个月;1年生存率48.84%(21/43);2年生存率2.33%(1/43)。其中中位生存时间(MST)二组差异有统计学意义(χ2=2.45,P=0.017)。主要毒副反应为轻中度骨髓抑制和恶心呕吐。结论两组方案对晚期NSCLC患者有相似的疗效和较好的毒副反应耐受性,总体GCis组略优于GCarb组,卡铂仍不能替代顺铂成为晚期NSCLC标准的一线化疗方案。
Objectives This study was designed to investigate whether patients with newly diagnosed advanced NSCLC receiving gemcitabine plus cisplatin (GCis) and gemcitabine plus carbarbamycin (GCarb) have the same therapeutic effect and whether carboplatin can completely replace cisplatin and become late Chemotherapy of non-small cell lung cancer patients with standard platinum-containing combination of two programs. Methods Gemcitabine 1 000 mg / m2, intravenous infusion, d1,8; cisplatin 75 mg / m2, d1 or 25 mg / m2, d1-3; carboplatin AUC = 5; every 21 d for 1 cycle, chemotherapy 3 ~ 6 cycles. Results Among the 76 patients in the GCis group, 1 case had CR, 13 cases had PR, 3 cases had MR, 7 cases had SD and 9 cases had PD, the effective rate was 42.42% (14/33). The disease control rate 72.73% (24/33); median TTP 5 months; median survival 14 months; 1-year survival rate 66.67% (22/33); 2-year survival rate 12.12% (4/33). In GCarb group, there were 13 cases of PR, 13 cases of MR, 7 cases of SD and 12 cases of PD, the effective rate was 30.23% (13/43); the disease control rate was 72.09% (31/43); the median TTP was 4 months; The median survival time was 11 months. The 1-year survival rate was 48.84% (21/43) and the 2-year survival rate was 2.33% (1/43). The median survival time (MST) between the two groups was statistically significant (χ2 = 2.45, P = 0.017). The main side effects are mild to moderate myelosuppression and nausea and vomiting. Conclusions Both regimens have similar curative effect and good toxicity tolerance to patients with advanced NSCLC. The overall GCis group is slightly superior to the GCarb group. Carboplatin can not replace cisplatin as the first-line chemotherapy regimen for advanced NSCLC.