中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
22期
1527-1531
,共5页
赵玲娣%张湘茹%李峻岭%王子平%王燕%郝学志%胡兴胜%周生余%孙燕%石远凯
趙玲娣%張湘茹%李峻嶺%王子平%王燕%郝學誌%鬍興勝%週生餘%孫燕%石遠凱
조령제%장상여%리준령%왕자평%왕연%학학지%호흥성%주생여%손연%석원개
癌,非小细胞肺%抗肿瘤联合化疗方案%治疗效果
癌,非小細胞肺%抗腫瘤聯閤化療方案%治療效果
암,비소세포폐%항종류연합화료방안%치료효과
Carcinoma,non-small-cell lung%Antineoplastic combined chemotherapy protocols%Treatment outcome
目的 探讨不同三代新药与铂联合一线双药方案对晚期非小细胞肺癌( NSCLC)患者的疗效.方法 回顾性分析2005年1月至2009年8月中国医学科学院肿瘤医院确诊的1112例晚期NSCLC患者应用4种三代新药(紫杉醇、吉西他滨、长春瑞滨和多西紫杉醇)与铂类(顺铂和卡铂)联合一线双药方案化疗的客观有效率(ORR)和无进展生存期(PFS),并进行统计学分析.结果 紫杉醇、吉西他滨、长春瑞滨和多西紫杉醇双药方案的ORR分别为35.6％、35.4％、25.9％和37.4％,长春瑞滨方案的ORR均显著低于其他3种方案(均P＜0.01).顺铂和卡铂双药方案的ORR分别为35.2％和33.5％(x2=0.352,P=0.569).非老年患者4种三代新药双药方案的ORR分别为34.8％、35.3％、23.2％和37.1％,长春瑞滨方案的ORR较低；鳞癌患者紫杉醇双药方案和吉西他滨双药方案的ORR分别为45.5％和28.4％(x2=5.250,P =0.026).4种三代新药联合卡铂方案的ORR分别为36.2％、16.7％、15.4％和32.0％,紫杉醇方案的ORR显著高于吉西他滨和长春瑞滨方案(P=0.018和P=0.034).获益患者去除后续治疗的影响后,4种三代新药双药方案的PFS分别为(3.67±0.19)、(2.95±0.18)、(3.05±0.36)和(3.40±0.37)个月,紫杉醇方案的PFS显著长于吉西他滨方案(x2 =7.037,P=0.008)；而卡铂双药方案的PFS[(3.65±0.20)个月]显著长于顺铂双药方案[(3.05±0.14)个月](x2 =6.102,P=0.014).结论 晚期NSCLC患者应用不同三代新药与铂联合一线双药方案化疗的ORR相似,与顺铂相比,卡铂双药方案可延长患者的PFS.
目的 探討不同三代新藥與鉑聯閤一線雙藥方案對晚期非小細胞肺癌( NSCLC)患者的療效.方法 迴顧性分析2005年1月至2009年8月中國醫學科學院腫瘤醫院確診的1112例晚期NSCLC患者應用4種三代新藥(紫杉醇、吉西他濱、長春瑞濱和多西紫杉醇)與鉑類(順鉑和卡鉑)聯閤一線雙藥方案化療的客觀有效率(ORR)和無進展生存期(PFS),併進行統計學分析.結果 紫杉醇、吉西他濱、長春瑞濱和多西紫杉醇雙藥方案的ORR分彆為35.6％、35.4％、25.9％和37.4％,長春瑞濱方案的ORR均顯著低于其他3種方案(均P＜0.01).順鉑和卡鉑雙藥方案的ORR分彆為35.2％和33.5％(x2=0.352,P=0.569).非老年患者4種三代新藥雙藥方案的ORR分彆為34.8％、35.3％、23.2％和37.1％,長春瑞濱方案的ORR較低；鱗癌患者紫杉醇雙藥方案和吉西他濱雙藥方案的ORR分彆為45.5％和28.4％(x2=5.250,P =0.026).4種三代新藥聯閤卡鉑方案的ORR分彆為36.2％、16.7％、15.4％和32.0％,紫杉醇方案的ORR顯著高于吉西他濱和長春瑞濱方案(P=0.018和P=0.034).穫益患者去除後續治療的影響後,4種三代新藥雙藥方案的PFS分彆為(3.67±0.19)、(2.95±0.18)、(3.05±0.36)和(3.40±0.37)箇月,紫杉醇方案的PFS顯著長于吉西他濱方案(x2 =7.037,P=0.008)；而卡鉑雙藥方案的PFS[(3.65±0.20)箇月]顯著長于順鉑雙藥方案[(3.05±0.14)箇月](x2 =6.102,P=0.014).結論 晚期NSCLC患者應用不同三代新藥與鉑聯閤一線雙藥方案化療的ORR相似,與順鉑相比,卡鉑雙藥方案可延長患者的PFS.
목적 탐토불동삼대신약여박연합일선쌍약방안대만기비소세포폐암( NSCLC)환자적료효.방법 회고성분석2005년1월지2009년8월중국의학과학원종류의원학진적1112례만기NSCLC환자응용4충삼대신약(자삼순、길서타빈、장춘서빈화다서자삼순)여박류(순박화잡박)연합일선쌍약방안화료적객관유효솔(ORR)화무진전생존기(PFS),병진행통계학분석.결과 자삼순、길서타빈、장춘서빈화다서자삼순쌍약방안적ORR분별위35.6％、35.4％、25.9％화37.4％,장춘서빈방안적ORR균현저저우기타3충방안(균P＜0.01).순박화잡박쌍약방안적ORR분별위35.2％화33.5％(x2=0.352,P=0.569).비노년환자4충삼대신약쌍약방안적ORR분별위34.8％、35.3％、23.2％화37.1％,장춘서빈방안적ORR교저；린암환자자삼순쌍약방안화길서타빈쌍약방안적ORR분별위45.5％화28.4％(x2=5.250,P =0.026).4충삼대신약연합잡박방안적ORR분별위36.2％、16.7％、15.4％화32.0％,자삼순방안적ORR현저고우길서타빈화장춘서빈방안(P=0.018화P=0.034).획익환자거제후속치료적영향후,4충삼대신약쌍약방안적PFS분별위(3.67±0.19)、(2.95±0.18)、(3.05±0.36)화(3.40±0.37)개월,자삼순방안적PFS현저장우길서타빈방안(x2 =7.037,P=0.008)；이잡박쌍약방안적PFS[(3.65±0.20)개월]현저장우순박쌍약방안[(3.05±0.14)개월](x2 =6.102,P=0.014).결론 만기NSCLC환자응용불동삼대신약여박연합일선쌍약방안화료적ORR상사,여순박상비,잡박쌍약방안가연장환자적PFS.
Objective To compare the chemotherapeutic efficacies of third-generation plus platinum doublets in advanced non-small cell lung cancer (NSCLC) patients.Methods A total of 1112 patients were diagnosed as advanced NSCLC at Chinese Academy of Medical Science and Cancer Hospital from January 2005 to August 2009.Their clinical efficacies and regimen compositions were retrospectively analyzed.All calculations were performed by SPSS 17.0.Results Differences in objective response rate (ORR) existed among four third-generation agents ( paclitaxel,gemcitabine,vinorelbine and docetaxel)plus platinum doublets. Their ORRs were 35.6％,35.4％,25.9％ and 37.4％ respectively (x2 =16.331,P =0.001 ).And vinorelbine doublets had the lowest ORR ( all P ＜0.01 ).The ORRs of cisplatin and carboplatin doublets were 35.2％ and 33.5％ respectively.There was no difference in ORR among them ( x2 =0.352,P =0.569 ).Subgroup analysis showed that the ORRs of four third generation plus platinum doublets were 34.8％,35.3％,23.2％ and 37.1％ in non-agers.And the vinorelbine doublets performed the worst.In the patients with squamous-cell lung cancer,the ORRs of paclitaxel and gemcitabine doublets were 45.5％ and 28.4％ respectively.And the paclitaxel doublets had the better performance ( x2 =5.250,P =0.026).When combined with carboplatin,the ORRs of four doublets were 36.2％,16.7％,15.4％and 32.0％ respectively.And the paclitaxel regimen was more effective than the gemcitabine and vinorelbine regimens (P =0.018 and P =0.034). The influences of subsequent therapy were nullified when the progression-free survival (PFS) was analyzed.The PFSs of these doublets were ( 3.67 ± 0.19 ),( 2.95 ±0.18),(3.05 ± 0.36) and (3.40 ± 0.37 ) months respectively.There was no difference among them.Pairwise comparisons showed that the mean PFS of patients on paclitaxel doublets was longer than those on gemcitabine doublets.And their PFSs were (3.67 ±0.19) and (2.95 ±0.18) months respectively (x2 =7.037,P =0.008 ).The PFSs of cisplatin and carboplatin doublets were ( 3.05 ± 0.14 ) and ( 3.65 ±0.20) months respectively.The patients on carboplatin doublets had a longer PFS than that of those on cisplatin doublets (x2 =6.012,P =0.014).Conclusions No difference exist in ORRs among different third-generation plus platinum doublets.But as the first-line treatment of advanced NSCLC,carboplatin doublets is superior to cisplatin doublets in terms of PFS.
