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目的观察多西紫杉醇联合吉西他滨和顺铂治疗晚期非小细胞肺癌(NSCLC)的临床疗效及安全性。方法将84例晚期NSCLC患者随机分为对照组42例和试验组42例。对照组予以静脉滴注1000～1250 mg·m~(-2)吉西他滨,第1,8天+静脉滴注25～30 mg·m~(-2)顺铂,第1~3天;试验组在对照组的基础上,联合75 mg·m~(-2)多西紫杉醇,静脉滴注1 h,第1天。2组患者一个周期均为21 d,共治疗2个周期。比较2组患者的临床疗效、血浆中分子标志物表达水平,以及不良反应的发生率。结果治疗后,对照组和试验组的客观缓解率分别为35.71%,38.10%,中位进展时间分别为6.46,7.82个月,1年生存率分别为40.48%,47.62%,2组比较差异均无统计学意义(P>0.05)。治疗后,试验组转化生长因子-β1的表达水平显著高于对照组(P<0.05),循环游离DNA的表达水平显著低于对照组(P>0.05)。治疗后,2组患者转化生长因子-α的表达水平比较差异无统计学意义(P>0.05),但均较治疗前显著降低(P<0.05)。试验组Ⅲ~Ⅳ级中性粒细胞减少及恶心呕吐的发生率显著低于对照组(P<0.05)。结论多西紫杉醇联合吉西他滨和顺铂治疗晚期NSCLC具有较好的临床疗效,可减轻不良反应的发生率。
Objective To observe the clinical efficacy and safety of docetaxel plus gemcitabine and cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Eighty-four patients with advanced NSCLC were randomly divided into control group (n = 42) and experimental group (n = 42). The control group was given gemcitabine 1000 ~ 1250 mg · m -2 intravenously, and intravenous drip of 25 ~ 30 mg · m -2 cisplatin on days 1 and 8 for the first 3 days. The experimental group On the basis of the control group, combined docetaxel 75 mg · m -2, intravenous infusion 1 h, the first day. The two groups of patients with a cycle of 21 d, a total of 2 cycles. The clinical efficacy, the level of plasma molecular markers and the incidence of adverse reactions were compared between the two groups. Results After treatment, the objective response rates of the control group and the experimental group were 35.71% and 38.10%, respectively. The median progression time was 6.46 and 7.82 months respectively. The 1-year survival rates were 40.48% and 47.62% No statistical significance (P> 0.05). After treatment, the expression of transforming growth factor-β1 in the experimental group was significantly higher than that in the control group (P <0.05), and the circulating free DNA expression was significantly lower than that in the control group (P> 0.05). After treatment, the expression of TGF-α in the two groups had no significant difference (P> 0.05), but both were significantly lower than those before treatment (P <0.05). The incidence of grade Ⅲ ~ Ⅳ neutropenia and nausea and vomiting in the experimental group was significantly lower than that in the control group (P <0.05). Conclusion Docetaxel combined with gemcitabine and cisplatin in the treatment of advanced NSCLC has good clinical efficacy and can reduce the incidence of adverse reactions.