GP 方案和吉非替尼单药一线治疗非小细胞 肺癌疗效比较
Comparison of GP Regimen and Gef itinib in First Line Treatment of Advanced Non2small Cell Lung Cancer
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摘要: 目的 对比分析以铂类为基础的GP(吉西他滨+ 顺铂) 联合化疗和单药吉非替尼( IRESSA) 一线治疗ⅢB2 Ⅳ期非小细胞肺癌的近期疗效和毒副作用。方法 60 例ⅢB～ Ⅳ期从未接受过化疗的非小细胞肺癌患者中,单用吉非替尼治疗26 例,GP 方案治疗34 例。吉非替尼组为吉非替尼250 mg/ d ; GP 组为吉西他滨1 250 mg/ m2, 第1, 8 天,顺铂75 mg/ m2, 第1 天。每三周为一周期,两周期后评价客观疗效及不良反应。结果 两组总有效率吉非替尼组26. 9 %(7/ 26), GP 组29. 4 %(10/ 34), P > 0. 05 ;疾病控制率吉非替尼组76. 9 %(20/ 26), GP 组50. 0 %(17/ 34), P < 0. 05 。GP 组主要存在骨髓抑制和胃肠道反应毒性( P < 0. 05), 吉非替尼组的毒性反应主要为皮疹和腹泻。结论 GP 方案和吉非替尼单药一线治疗非小细胞肺癌(NSCLC) 可获得一致的客观有效率,但吉非替尼单药的疾病控制率显著高于GP 组,且其毒副反应较GP 组轻微,患者均可完全耐受。吉非替尼单药口服可考虑作为治疗晚期化疗难耐受的NSCLC 患者的一线方案。Abstract: Objective Analyze const rastively the clinical efficacy and toxicity of GP ( Gemcitabine + Cispla2 tin) regimen and single agent Gefitinib in f rist line t reatment of ⅢB～ Ⅳstage non2small cell lung cancer (NSCLC) . Methods Sixty cases with stage ⅢB～ ⅣNSCLC pathologically proved were enrolled in this study. Oral Gefitinib 250mg daily were given to twenty2six cases ; the other thirty2four cases were t reated with Gemcitabine ( GEM, 1250 mg/ m2 ) on d 1 and d 8 and Cisplatin (DDP, 75 mg/ m2 ) on d1. Every three weeks (21days) as a cycle. The efficacy and adverse effect s were evaluated af ter two cycles of t reatment . Results The overall response rate (ORR) of single agent Gefitinib group was 26. 9 %(7/ 26), and that of combined GP group was 29. 4 %(10/ 34) ; there is no statistically significant difference ( P > 0. 05) . The clinical disease cont rol rate of Gefitinib group was 76. 9 %(20/ 26), and that of GP group was 50. 0 %(17/34) ; the difference was significant ( P < 0. 05) . The main toxicities included the alimentary t ract reaction and bone marrow depression were exist in combine GP group ; The Major toxicity in IRESSSA group is skin rash and diarrhea. Conclusion Gefitinib and GP regimen for advanced NSCLC have similar response rate ( P > 0. 05) . The former can get more clinical disease cont rol rate, and has lower toxicity. Gefitinib may be accepted as first line in the t reatment of patient s with bad constitution who is untolerable for chemotherapy.
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