DG及DP方案治疗晚期非小细胞肺癌的临床研究

目的 探讨多西紫杉醇＋吉西他滨（DG方案）和多西紫杉醇＋顺铂(DP方案)治疗晚期非小细胞肺癌的临床疗效和毒性反应。方法 经病理学或细胞学确诊不可手术的Ⅲb／Ⅳ期NSCLC患者125例，DG组65例，DP组60例。DG组：多西紫杉醇100㎎/㎡，d1；吉西他滨1 100㎎/㎡，d1、8。DP组:多西紫杉醇100㎎/㎡，d1; 顺铂80㎎/㎡，d2。对临床疗效和毒副反应进行对比观察。结果 有效率DG组为46.2%，DP组为45%，两组差异无统计学意义（P﹥0.05）。DG组和DP组中位生存期分别为12.4月和11.7月，一年生存率为50.8%和46.7%，均无统计学差异（P >0.05）。毒副反应均以骨髓抑制、胃肠反应为主，可耐受。DP组Ⅲ~Ⅳ度白细胞下降、恶心/呕吐、腹泻较DG组严重（P﹤0.05）。其他毒副反应相似。结论 DG方案和DP方案治疗晚期NSCLC均具有较好的耐受性和疗效，毒副反应可以耐受。DG方案毒副反应较DP方案更少、更轻，可作为晚期NSCLC较理想的化疗方法之一。

A Clinical Study of DG and DP in Treating Advanced Non-Small Cell Lung Cancer

【Abstact】 Objective To observe the curative efficacy and side effects of gemcitabine or cisplatin combined with docetaxel in treating advanced non-small cell lung cancer. Methods There were 125 inoperable patients with stage Ⅲb/Ⅳ confirmed NSCLC through pathology or cytology．65 cases in DG(docetaxel plus gemcitabine)group and 60 cases in DP(docetaxel plus cisplatin)group. DG group: docetaxel 100mg/m2, d1; gemcitabine 1 100mg/m2, d1,8. DP group: docetaxel 100mg/m2, d1; cisplatin 80mg/m2, d2. The efficacy and side effects were analyzed after two cycles of chemotherapy．Results The response rates(CR+PR)were 46.2％ in the DG group and 45％ in the DP group．No significant statistical difference was found between the two groups(P > 0.05)．MST of DG and DP groups, respectively, were 12.4 months and 11.7 months, and one year survival rate of the two groups were 50.8% and 46.7%. The two groups were no significant difference in the two aspects(P＞0.05). The major side effects were myelosuppression and reactions of gastrointestinal. All the adverse reactions were tolerable．The incidence rates of grade Ⅲ~Ⅳ leucopenia, nausea/vomiting and diarrhea in group DP were higher than those in group DG (P<0.05)．The others side effects of the 2 groups were similar. Conclusion DG and DP regimens with manageable toxicity have good antitumor activity of advanced NSCLC，but the toxicities in group DG are less serious than those in group DP. So the DG regiment might be ideal in the treatment of advanced NSCLC.