目的探讨长春瑞滨(NVB)联合顺铂(DDP)的NP方案时辰化疗治疗非小细胞肺癌(NSCLC)的临床疗效和安全性。方法 2007年5月至2010年5月期间收治的140例NSCLC患者,选取接受NP时辰化疗的45例患者作为试验组,在17:00至21:00连续4h静脉滴注NVB,在10:00点至22:00连续12h静脉滴注DDP,在2:00点至5:00点连续3h静脉滴注紫杉醇。同时选取46例接受常规化疗的患者作为对照组,用药方案和用药剂量与试验组相同,均为上午时间用药。观察和比较两组患者临床疗效、生活质量改善情况和不良反应。结果试验组完全缓解率(CR)为11.1%,有效率(RR)为55.6%,临床控制率为88.9%,均显著高于对照组(均P<0.05)。试验组生存时间(MST)为(15.24±2.56)个月,无进展生存时间(PFS)为(8.04±1.57)个月,显著高于对照组(P<0.05)。试验组1年和2年生存率分别为57.8%和48.9%,显著高于对照组(P<0.05);试验组总体健康评分为(87.23±7.44)分,显著高于对照组的(76.45±7.11)分(P<0.05);试验组Ⅱ度以上白细胞下降发生率为28.9%,显著低于对照组的52.2%,差异有统计学意义(P<0.05)。试验组患者Ⅱ度以上恶心呕吐发生率为15.6%,显著低于对照组的41.3%,差异有统计学意义(P<0.05)。试验组Ⅱ度以上血小板下降发生率为4.4%,显著低于对照组10.9%(P<0.05)。结论与常规化疗比较,NP方案时辰化疗可延长NSCLC患者的生存时间,改善患者化疗后生活质量,不良反应耐受性好,安全性高,综合疗效优于常规化疗。 Objective To investigate the clinical efficacy and safety of NP regimen chemotherapy with vinblastine (NVB) combined with cisplatin (DDP) in the treatment of non-small cell lung cancer (NSCLC). Methods Forty-five patients with NSCLC admitted to our hospital from May 2007 to May 2010 were enrolled in this study. Twenty-five patients undergoing NP chemotherapy were enrolled in this study. NVB was infused intravenously for 4 hours between 17:00 and 21:00 at 10:00. DDP was given intravenously at 22:00 for 12h and intravenously for 3h at 2:00 p.m. to 5:00 p.m. At the same time, 46 patients receiving conventional chemotherapy were selected as the control group. The medication regimen and dosage were the same as those in the experimental group. The clinical efficacy, quality of life improvement and adverse reactions in both groups were observed and compared. Results The complete remission rate (CR) was 11.1%, the effective rate (RR) was 55.6% and the clinical control rate was 88.9% in the experimental group, which were significantly higher than those in the control group (all P <0.05). The survival time (MST) of the experimental group was (15.24 ± 2.56) months, the progression-free survival time (PFS) was (8.04 ± 1.57) months, which was significantly higher than that of the control group (P <0.05). The 1-year and 2-year survival rates in the experimental group were 57.8% and 48.9%, respectively, significantly higher than those in the control group (P <0.05). The overall health score of the experimental group was (87.23 ± 7.44) points, significantly higher than that of the control group (76.45 ± 7.11) (P <0.05). The incidence of leukopenia of grade Ⅱ or higher in the experimental group was 28.9%, which was significantly lower than that of the control group (52.2%, P <0.05). The incidence of nausea and vomiting of grade Ⅱ or higher in the test group was 15.6%, which was significantly lower than that of the control group (41.3%), the difference was statistically significant (P <0.05). The incidence of thrombocytopenia above grade Ⅱ in trial group was 4.4%, which was significantly lower than that in control group (10.9%, P <0.05). Conclusion Compared with conventional chemotherapy, chemotherapy with time-course NP can prolong the survival time of patients with NSCLC and improve the quality of life after chemotherapy. The tolerability of adverse reactions is good, the safety is high, and the comprehensive curative effect is better than that of conventional chemotherapy.