国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (5): 321-323.doi: 10.3760/cma.j.issn.1673422X.2015.05.001

• 论著 •    下一篇

紫杉醇脂质体联合顺铂治疗非小细胞肺癌脑转移的临床观察

刘娜, 程俊, 孟令占, 刘勇   

  1. 重庆市中医院肿瘤科
  • 出版日期:2015-05-08 发布日期:2015-05-12
  • 通讯作者: 程俊，liunach2010@163.com

Paclitaxel liposome combined with cisplatin chemotherapy in nonsmall cell lung cancer with brain metastasis

 LIU  Na, CHENG  Jun, MENG  Ling-Zhan, LIU  Yong   

  1. Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine
  • Online:2015-05-08 Published:2015-05-12
  • Contact: Cheng Jun liunach2010@163.com

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被引次数

6

摘要：         目的 观察紫杉醇脂质体联合顺铂治疗非小细胞肺癌（NSCLC）脑转移的疗效和不良反应。方法 对28例经病理或细胞学检查确诊的NSCLC脑转移初治患者采用紫杉醇脂质体联合顺铂进行化疗：紫杉醇脂质体135 mg/m2第1天静脉滴注3 h，顺铂25 mg/m2第1～3天静脉滴注，每21天为1疗程。化疗前予以常规抗过敏治疗。结果 28例患者可评价，总共完成101个治疗周期，平均3.6个周期／例。全身病灶的疗效：完全缓解(CR) 0 例，部分缓解(PR) 13例（46.43％），稳定(SD)11 例（39.28％），进展（PD）4 例（14.29％），有效率(RR)为46.43％，疾病控制率(DCR)为85.71％。颅内转移灶的总体疗效：CR 0例，PR 6 例（21.43％），SD 15 例（53.58％），PD 4 例（14.29％），RR 为21.43％，DCR 为75.00％。颅内转移灶与全身病灶的DCR差异无统计学意义（χ2=0.15，P=0.30），RR比较差异具有统计学意义（χ2=3.90，P=0.03）。颅内转移灶的中位疾病进展时间（TTP）为6.2个月，全身病灶的中位PFS为7.2个月，两者比较差异具有统计学意义（χ2=6.43, P＜0.05）。不良反应为骨髓抑制、消化道反应、转氨酶升高、脱发、神经毒性等，其中骨髓抑制为主要的不良反应，经对症处理后均能耐受。结论 紫杉醇脂质体联合顺铂治疗NSCLC脑转移疗效肯定，患者能耐受，依从性好，不良反应小。

Abstract: ObjectiveTo evaluate the clinical efficacy and toxicity of paclitaxel liposome combined with cisplatin chemotherapy in NSCLC with brain metastasis. MethodsTwentyeight patients were newly diagnosed NSCLC with brain metastasis (confirmed by pathology or cytology). The patients were treated with paclitaxel liposome (135 mg/m2 ) on day 1 intravenous drip for 3 hours, cisplatin, 25 mg/m2 on day 13. The course of treatment was 21 days. The patients accepted the antiallergy treatment before chemotherapy. ResultsTwentyeight patients could be evaluated, and 101 treatment cycles were completed (3.6 cycles per patient). General lesion assessment presented that no patient got complete remission (CR), 13 patients (46.43%) got a partial response (PR), 11 (39.28%) had a stable disease(SD) and 4 (14.29％) had a progressive disease (PD). The objective response rate (RR) was 46.43％, and the disease control rate (DCR) was 85.71％. Local cerebral response assessment showed that no patient got CR, 6 patients (21.43%) got a PR, 15 (53.58%) had a SD and 4 (14.29％) had a PD. The RR was 21.43％, and the DCR was 85.71％. There was a significant difference in the RR (χ2=3.90, P=0.03) but not in the DCR (χ2=0.15, P=0.3) between the local cerebral disease and the general lesion. The median time to disease progression (TTP) for general lesion and local cerebral were 7.2 months and 6.2 months, respectively (χ2=6.43, P<0.05). The adverse reactions included bone marrow suppression, gastrointestinal reactions, elevated transaminases, alopecia, neurotoxicity, etc. All of these could be well controlled. ConclusionPaclitaxel liposome combined with cisplatin regimen demonstrates a higher efficacy and well tolerable against main metastasis of NSCLC, and the adverse effects are minor.