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目的探讨不同化疗剂量强度对肺癌患者近期疗效以及不良反应的影响。方法临床纳入Ⅲb~Ⅳ期非小细胞肺癌患者396例,所有患者均采用多西他赛单药方案二线化疗。采用实体瘤化疗疗效对治疗效果进行评价,同时观察各化疗剂量强度引发肺癌患者不良反应情况。结果根据患者化疗的相对剂量强度,分为低剂量组(<0.65),中剂量组(0.66~0.74),高剂量组(≥0.75)。其中,高剂量组治疗有效率为69.52%,中剂量组治疗有效率为57.44%,低剂量组治疗有效率为40.63%。高剂量组临床治疗有效率明显高于低剂量组、中剂量组,差异有显著性(P<0.05);化疗期间主要不良反应为白细胞、血小板及红细胞数目下降,胆红素水平升高,转氨酶升高,腹泻、腹痛、恶心、呕吐等胃肠道反应。化疗期间不良反应发生率高剂量组为45.71%,中剂量组为28.72%,低剂量组为25.00%;高剂量组不良反应发生率明显高于低剂量组、中剂量组,差异有显著性(P<0.05);化疗后随访3年发现,高剂量组1、2、3年生存率分别为82.86%、60.95%、28.57%,中剂量组1、2、3年生存率分别为81.03%、46.15%、16.41%,低剂量组1、2、3年生存率分别为79.17%、38.54%、11.46%。高剂量组1年生存率与低剂量组、中剂量组比较无差异(P>0.05),而2年、3年生存率高剂量组明显高于低剂量组、中剂量组(P<0.05)。结论高剂量强度的化疗药物,能够有效提高肺癌患者近期疗效。但其临床不良反应发生率亦较高。因此,对肺癌患者进行化疗剂量的选择时,需要根据患者的实际情况进行考虑。同时,还需要密切监测患者的各项不良反应。
Objective To investigate the effects of different doses of chemotherapy on the short-term efficacy and side effects of lung cancer patients. Methods A total of 396 patients with stage Ⅲb-Ⅳ non-small cell lung cancer were included in the study. All patients received second-line chemotherapy with docetaxel alone. The curative effect of solid tumor chemotherapy was evaluated, and the adverse reaction of lung cancer patients caused by the dose intensity of each chemotherapy was observed. Results According to the relative dose intensity of chemotherapy, the patients were divided into low dose group (0.65), middle dose group (0.66-0.74) and high dose group (≥0.75). Among them, the high-dose treatment efficiency was 69.52%, the middle-dose treatment efficiency was 57.44%, low-dose treatment efficiency was 40.63%. The effective rate of clinical treatment in high-dose group was significantly higher than that in low-dose and medium-dose groups (P <0.05). The main adverse reactions during chemotherapy were white blood cells, the number of platelets and erythrocytes decreased, the level of bilirubin increased, Elevated, diarrhea, abdominal pain, nausea, vomiting and other gastrointestinal reactions. The incidence of adverse reactions during chemotherapy was 45.71% in high-dose group, 28.72% in middle-dose group and 25.00% in low-dose group. The incidence of adverse reactions in high-dose group was significantly higher than that in low-dose group and middle-dose group The 3-year follow-up after chemotherapy showed that the 1-, 2- and 3-year survival rates of the high-dose group were 82.86%, 60.95% and 28.57%, respectively. The 1, 2 and 3-year survival rates of the medium dose group were 81.03% 46.15% and 16.41% respectively. The 1, 2, 3-year survival rates of low-dose group were 79.17%, 38.54% and 11.46% respectively. The 1-year survival rate of the high-dose group was not significantly different from that of the low-dose and medium-dose groups (P> 0.05), but the 2-year and 3-year survival rates were significantly higher than those of the low and medium dose groups . Conclusions High-dose and high-intensity chemotherapy drugs can effectively improve the short-term efficacy of lung cancer patients. However, the incidence of clinical adverse reactions is also higher. Therefore, the choice of chemotherapy dose for patients with lung cancer need to be considered according to the actual situation of patients. At the same time, there is also a need to closely monitor the patient’s adverse reactions.