摘要
目的 评价MVP和TVP两种方案治疗晚期非小细胞肺癌的有效率、毒性和生存期。方法 66例晚期非小细胞肺癌随机分为两组 ,MVP组 3 2例 ,TVP组 3 4例 ,两组患者资料相似。MVP组 :丝裂霉素(MMC) 6～ 8mg/m2 ,静注 ,第 1天 ;长春花碱酰胺 (VDS) 2～ 3mg/m2 ,静滴 ,第 1、8天 ;顺铂 (DDP) 70～ 80mg/m2 ,静滴 ,第 1天或分两天。TVP组 :吡喃阿霉素 (THP) 40～ 5 0mg/m2 ,第 1天 ,VDS和DDP同上。两方案均为一周期 2 1天 ,每例完成 2～ 4周期。结果 MVP组有效率为 3 4% (完全缓解 1例 ,部分缓解 10例 ) ,TVP组有效率为 5 6% (完全缓解 1例 ,部分缓解 18例 ) ,TVP有效率高于MVP组 ,但统计学无意义 ( χ2 =2 .2 69,P=0 .13 2 )。TVP组Ⅲ +Ⅳ度骨髓抑制发生率高于MVP组 ,其中粒细胞抑制有显著性差异 ( 79%与 44 % ,χ2=7.45 8,P =0 .0 0 6)。MVP组与TVP组的中位生存期分别为 12个月与 8个月 ,1年生存率 5 3 %与 2 4% ( χ2=4.943 ,P =0 .0 2 6) ,2年生存率 17%与 6% ,3年生存率 6%与 0。结论 MVP有效率相对较低 ,但血液毒性低 ,患者生存期和生存率高 ,是晚期非小细胞肺癌化疗的合适方案。TVP方案近期有效率高 ,但血液毒性明显 ,与MVP方案比较 。
Objective To evaluate the response, adverse effects and survival of MVP regimen and TVP regimen. Methods Sixty six patients with advanced non small cell lung cancer were randomized into two groups:MVP arm (32 patients, mitomycin C 6 8 mg/m 2 d1, vindesine 2 3 mg/m 2 d1 and d8, cisplatin 70 80 mg/m 2 d1) and TVP arm (34 patients, pirarubicin 40 50 mg/m 2 d1, vindesine and cisplatin were the same as arm MVP). Characteristics of the patients were similar in two arms. All patients received two to four cycles of chemotherapy. Results The overall responses were 34% (11/32) in the MVP arm and 56% (19/34) in the TVP arm. There were 1 complete response, 10 partial responses in the MVP arm and 1 complete response, 18 partial responses in the TVP arm. TVP regimen appeared to have a higher objective response, but no statistically significant difference in the response was observed between two regimens (χ 2=2.269, P=0.132). Main side effects were hematological toxicities. Grade Ⅲ+Ⅳ hematological toxicities were significantly higher in the patients of arm TVP than arm MVP, especially neutropenia (79% vs 44%, χ 2=7.458, P=0.006). Median survival time was 12 months vs 8 months, and 1 , 2 , 3 year survival rates were 53% vs 24% (χ 2=4.943, P=0.026), 17% vs 6%, 6% vs 0, for arm TVP and arm MVP, respectively. Conclusion MVP regimen has a lower response rate and longer survival time but less hematological toxicities than TVP regimen. The results suggest MVP regimen is a safe and active regimen for advanced non small cell lung cancer.
出处
《中国肺癌杂志》
CAS
2003年第3期195-197,共3页
Chinese Journal of Lung Cancer
