中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
4期
1486-1491
,共6页
王竞%刘峰%黄登笑%姜斌
王競%劉峰%黃登笑%薑斌
왕경%류봉%황등소%강빈
癌,非小细胞肺%顺铂%长春瑞滨%生存期
癌,非小細胞肺%順鉑%長春瑞濱%生存期
암,비소세포폐%순박%장춘서빈%생존기
Carcinoma,non-small-cell lung%Cisplatin%Vinorelbine%Survival
目的探讨顺铂与长春瑞滨联用( NP方案)在中国人非小细胞肺癌( non-small cell lung canc-er,NSCLC)根治术后的疗效。方法2002年1月至2004年11月451例Ⅰ、Ⅱ、Ⅲa期NSCLC根治术后患者接受或不接受NP方案辅助化疗并随访5年。对两组患者的总生存期( OS)及无病生存期( DFS)进行评估,并记录化疗的不良反应。分层分析评估影响OS期和DFS期的潜在因素。结果化疗组86.7%患者至少完成4个疗程的治疗。化疗组患者的生存期显着长于观察组( P<0.001)。相比观察组,2年和5年的生存率提高3.8%[危险比(HR)=0.674,95%可信区间(CI)0.554~0.820,P<0.0001]和13.0%(HR=0.732,95%CI 0.579~0.926,P=0.009)。4年的DFS改善2.1%(HR=0.327,95% CI 0.214~0.500,P<0.0001)。多因素分析显示:年龄,组织分型,病理分期等因素能影响化疗组患者的预后,而非性别和吸烟状况。多数患者有产生Ⅰ~Ⅲ级的药物不良反应,但无治疗相关死亡。结论 NP方案作为NSCLC术后辅助化疗方案在中国NSCLC患者中是有效且可以被耐受的。
目的探討順鉑與長春瑞濱聯用( NP方案)在中國人非小細胞肺癌( non-small cell lung canc-er,NSCLC)根治術後的療效。方法2002年1月至2004年11月451例Ⅰ、Ⅱ、Ⅲa期NSCLC根治術後患者接受或不接受NP方案輔助化療併隨訪5年。對兩組患者的總生存期( OS)及無病生存期( DFS)進行評估,併記錄化療的不良反應。分層分析評估影響OS期和DFS期的潛在因素。結果化療組86.7%患者至少完成4箇療程的治療。化療組患者的生存期顯著長于觀察組( P<0.001)。相比觀察組,2年和5年的生存率提高3.8%[危險比(HR)=0.674,95%可信區間(CI)0.554~0.820,P<0.0001]和13.0%(HR=0.732,95%CI 0.579~0.926,P=0.009)。4年的DFS改善2.1%(HR=0.327,95% CI 0.214~0.500,P<0.0001)。多因素分析顯示:年齡,組織分型,病理分期等因素能影響化療組患者的預後,而非性彆和吸煙狀況。多數患者有產生Ⅰ~Ⅲ級的藥物不良反應,但無治療相關死亡。結論 NP方案作為NSCLC術後輔助化療方案在中國NSCLC患者中是有效且可以被耐受的。
목적탐토순박여장춘서빈련용( NP방안)재중국인비소세포폐암( non-small cell lung canc-er,NSCLC)근치술후적료효。방법2002년1월지2004년11월451례Ⅰ、Ⅱ、Ⅲa기NSCLC근치술후환자접수혹불접수NP방안보조화료병수방5년。대량조환자적총생존기( OS)급무병생존기( DFS)진행평고,병기록화료적불량반응。분층분석평고영향OS기화DFS기적잠재인소。결과화료조86.7%환자지소완성4개료정적치료。화료조환자적생존기현착장우관찰조( P<0.001)。상비관찰조,2년화5년적생존솔제고3.8%[위험비(HR)=0.674,95%가신구간(CI)0.554~0.820,P<0.0001]화13.0%(HR=0.732,95%CI 0.579~0.926,P=0.009)。4년적DFS개선2.1%(HR=0.327,95% CI 0.214~0.500,P<0.0001)。다인소분석현시:년령,조직분형,병리분기등인소능영향화료조환자적예후,이비성별화흡연상황。다수환자유산생Ⅰ~Ⅲ급적약물불량반응,단무치료상관사망。결론 NP방안작위NSCLC술후보조화료방안재중국NSCLC환자중시유효차가이피내수적。
Objective To determine the efficacy of post-operative chemotherapy with cisplatin plus vinorelbine ( NP) in Chinese patients with non-small cell lung cancer ( NSCLC ) .Methods A total of 451 patients NSCLC at stageⅠ,Ⅱ,and ⅢA after surgical resection were treated with cisplatin plus vimorelbine for 4 cycles or volunteers as observation between January 2002 and November 2004 and were followed for five years .The therapeutic efficacy was evaluated for the overall survival (OS)and disease-free survival(DFS),and the adverse effects were recorded.The potential factors affecting the lengths of OS and DFS were analyzed by multivariate analysis . Results Most patients ( 86.7%) completed at least 4 cycles of treatment .Patients with chemotherapy survived significantly longer than those in the observation group ( P<0.001 ) .The absolute improvements in the 2 and 5-year OS were 3.8%[hazard ratio(HR)=0.674,95% confidence interval(CI):0.554-0.820,P<0.0001]and 13.0%(HR=0.732,95% CI:0.579-0.926,P=0.009),respectively.The improvement at 4-year DFS was 2.1%(HR=0.327 ,95% CI:0.214-0.500 , P <0.0001 ) .Stratification analysis revealed that older age , histological type , pathological degree ,but not the gender and smoking status were independent factors affecting the lengths of survival in this population .Many patients ( 63.3%) had gradeⅠ-Ⅲ of tolerable adverse effects , and there was no treatment-related death.Conclusions Post-operative chemotherapy with NP regimen is effective and tolerable in Chinese patients with NSCLC .