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目的对比GP方案与NP方案治疗晚期非小细胞肺癌的临床效果和不良反应。方法 45例晚期非小细胞肺癌患者中22例应用吉西他滨1250mg/m~2,第1、8天,静脉滴注,顺铂75mg/m~2,第1天,静脉滴注;23例应用长春瑞滨25mg/m~2,第1、8天,静脉滴注,顺铂75mg/m~2,第1天,静脉滴注,同时给予止吐、水化、碱化尿液等处理,21天为1个化疗周期,2个化疗周期后评价治疗效果,观察毒副反应。结果 NP组(A组)有效率为39.1%(9/23),初治有效率为45.5%(5/11),复治有效率为33.3%(4/12);GP组(B组)有效率为40.9%(9/22),初治有效率为50.0%(5/10),复治有效率为41.7%(5/12)。两组间有效率及初治复治有效率比较无显著性差异(P>0.05)。GP组比NP组复治患者的疗效好(P>0.05)。两组均显示初治患者的疗效优于复治患者,ⅢB期患者优于Ⅳ期患者(P>0.05),NP组腺癌的疗效优于GP组腺癌(46.7%比37.5%),GP组鳞癌的疗效优于NP组鳞癌(50.0%比25.0%),但均无显著性差异(P>0.05)。骨髓抑制为两组主要毒性反应,其中GP组Ⅲ~Ⅳ度血小板数下降高于NP组(21.7%比18.2%),NP组Ⅲ~Ⅳ度白细胞数下降高于GP组(27.3%比17.4%),但差异无显著性(P>0.05)。结论 GP方案与NP方案治疗晚期非小细胞肺癌,近期疗效显著,不良反应可耐受,值得临床推广使用。
Objective To compare the clinical effects and adverse reactions of GP and NP regimens in the treatment of advanced non-small cell lung cancer. Methods Forty-five patients with advanced non-small cell lung cancer were treated with gemcitabine 1250mg / m 2 on days 1 and 8, intravenous infusion of cisplatin 75mg / m 2 on day 1, and intravenous drip on day 1 and 23 Ruibin 25mg / m ~ 2, the first and eighth days, intravenous drip, cisplatin 75mg / m ~ 2, the first day, intravenous infusion, given antiemetic, hydration, alkalinization of urine and other treatment, 21 Day for a chemotherapy cycle, two cycles of chemotherapy to evaluate the therapeutic effect, observe the side effects. Results The effective rate of NP group (A group) was 39.1% (9/23), the initial effective rate was 45.5% (5/11), and the effective rate of retreatment was 33.3% (4/12) The effective rate was 40.9% (9/22), the initial effective rate was 50.0% (5/10), and the effective rate of retreatment was 41.7% (5/12). There was no significant difference between the two groups (P> 0.05). The GP group had better curative effect than the NP group (P> 0.05). The efficacy of NP in group NP was superior to that in GP group (46.7% vs. 37.5%), and GP in GP group was superior to that in IV group (P> 0.05) The curative effect of squamous cell carcinoma was better than that of NP squamous cell carcinoma (50.0% vs. 25.0%), but no significant difference (P> 0.05). Myelosuppression was the major toxic reaction in both groups. The number of Ⅲ ~ Ⅳ platelets in GP group was significantly lower than that in NP group (21.7% vs 18.2%). The number of Ⅲ ~ Ⅳ leukocyte in NP group was lower than that in GP group (27.3% vs. 17.4% ), But the difference was not significant (P> 0.05). Conclusion GP and NP regimens are effective in the treatment of advanced non-small cell lung cancer in the near future. The adverse reactions are tolerable and worthy of clinical application.