TC和MVP治疗晚期非小细胞肺癌前瞻随机研究
药物疗法,,],癌,非小细胞肺;药物疗法;方案评价,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 评价TC和MVP两种方案治疗晚期非小细胞肺癌(NSCLC)有效率、毒性和生存期。方法68例晚期NSCLC病人随机分为两组:TC组34例,MVP组34例。TC组给予国产紫杉醇(Paclitaxel)175 mg/m2静滴第1天;卡铂(CBP)300 mg/m2静滴第2天。MVP组给予丝裂霉素(MMC)6~8 mg/m2静滴第1天;长春花碱酰胺(VDS)2~3 mg/m2,静滴第1、8天;顺铂(DDP)70~80 mg/m2,静滴第1、2天。两方案均为每周期21 d,每例完成2~4周期。结果 TC组有效率为62%(完全缓解1例,部分缓解20例),MVP组有效率为26%(完全缓解1例,部分缓解8例),TC组有效率显著高于MVP组(χ2=8.589,P<0.05)。恶心、呕吐及骨髓抑制为主要化疗反应。MVP组Ⅲ、Ⅳ度恶心、呕吐发生率高于TC组,差异有显著性(χ2=7.503,P<0.01)。Ⅲ、Ⅳ度骨髓抑制MVP组稍高于TC组,但差异无显著性。TC组与MVP组的中位生存期分别为10个月与8个月,1年生存率为47%与20%(χ2=5.321,P<0.05),2年生存率为17%与6%,3年生存率为2%与0。结论 TC组有效率高于MVP组,且恶心、呕吐和骨髓抑制发生率低,该方案是晚期非小细胞肺癌化疗的较佳方案。[关键词] 癌,非小细胞肺;药物疗法;方案评价
A PROSPECTIVE RANDOMIZED STUDY OF TC AND MVP IN ADVANCED NONSMALL CELL LUNG CANCER
YU JIE, YI XIMEI, ZHANG NAN
(Department of Internal Medicine, The Third Peoples Hospital of Qingdao, Qingdao 266041,China)
[ABSTRACT]ObjectiveTo evaluate the response, adverse effects and life span of TC and NVP therapeutic regimens for nonsmall cell lung cancer (NSCLC).MethodsSixtyeight patients with advanced NSCLC were randomized into two groups: TC group (n=34, paclitaxel 175 mg/m2, d1; carboplatin 300 mg/m2, d2) and MVP group (n=34, mitomycin C 6-8 mg/ m2, d1; vindesine 2-3 mg/m2 d1 and d8; cisplatin 70-80 mg/m2, d1 and d2 ). All patients received two to four courses of chemotherapy. ResultsThe overall response was 62% (21/34) in TC group and 26% (9/34) in MVP group. There was one complete response, 20 partial responses in TC group; one complete response, and eight partial response in MVP group. TC regimen appeared to have a higher objective response with statistical difference between two regimens (χ2=8.589, P<0.05). Major side effects were myelosuppression and nausea/vomiting, especially grade Ⅲ,Ⅳnausea/vomiting were significantly higher in MVP than TC (26% and 3%, χ2=7.503, P<0.01). Grade Ⅲ,Ⅳ myelosuppression was higher in MVP than TC, but with no statistical significance existed in the two groups. Median survival time was 10 months vs eight months, and 1,2,3year survival rates were 47% vs 20% (χ2=5.321, P<0.05),17% vs 6%,2% vs 0, for TC and MVP, respectively.ConclusionTC regimen has a higher response rate and longer survival time, less nausea /vomiting and myelosuppression than MVP regimen. TC regimen is a safe and active regimen for advanced nonsmall cell lung cancer. ......
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