【摘要】 目的:评价TP方案时间化学治疗晚期非小细胞肺癌的疗效和安全性。方法:紫杉醇135mg/m2+生理盐水250ml,第1天,03:00～05:00静脉输注,其中高峰输注时间03:30～04:30,输注速度150ml/h,其余时间输注速度100ml/h;顺铂80mg/m2+生理盐水500ml,第2天,15:30～16:30静脉输注,其中高峰输注时间15:30～16:30,输注速度300mL/h,其余时间输注速度为200ml/h;每位患者至少接受2个疗程化疗。结果:40例非小细胞肺癌(NSCLC)完全缓解1例,部分缓解12例,稳定18例,进展9例,有效率为32.5%(13/40),临床控制率为77.5%(31/40)。化疗后Karnofsky评分显著提高(P=0.032)。生活质量改善率为40%,功能状态改善率为67.5%,临床症状改善率为80%。全组无疾病进展时间4.1个月(95%CI,2.9～6.9),中位生存时间7、8个月,一年生存率为37.1%(13/35)。骨髓抑制是主要的毒副作用,第1个疗程后粒细胞降低发生率37.5%(15/40),但在第2个疗程加用粒细胞集落刺激因子(G-CSF)后降至12.5%(5/40),Ⅲ或Ⅳ度粒细胞减少分别发生在10%(4/40)和2.5%(1/40)的患者中。腹泻和神经病变通常是轻度的,经对症处理可缓解。结论:TP方案时间化学治疗晚期非小细胞肺癌疗效确切,可以改善生活质量,不良反应可以耐受,安全性高,可在临床上推广。更多还原

【Abstract】 objective:To evaluate the efficacy and safety of paclitaxol plus cisplatin in the chronochemotherapyforadvanced non-small cell lung cancer.Methods Fifty.three advanced non-small cell lungcancer received:Paclitaxol 135 mg/m2 in norma saline 250 ml ivdrip from 3am to 5 am(24.hour time.scale)in first day.Peak infusion time was at 4:30am,infusion speed was 150 mL/h,holding infusion speed of other infusion time was 100 ml/h.DDP 80mg/m2 in normal saline 500 ml ivdrip from 3pm to 5pm(24-hour time-scale)day 2.Peak in fusion time was from 3:30pm to 4:30pm,infusion speed was 300 ml/h,holding infusion speed of other infusion time was 200 ml/h.The schedule was repeated every 21 days.Each patient at least had received 2course of chrono-chemotherapy.Results 1 patient had complete response and 12 patients partial complete.18 patients had stable disease and 9 patients had progressive disease.The overall responserate was 32.5%.disease control rate was 77.5%.Time to progress was 4.1 months(95% CI,2.9-6.9),the median survival duration was 7.8 months.the 1-year survival was 37.1% Myelosuppression was the principal toxicity.Granulocytopenia occurred in 37.5%(15/40)of patients after the first course,but decreased to 12.5%(5/40)during the second course after introduction of G-CSF.Grade 3 or 4 granulocytopenia occuredin 10%(4/40)and 2.5%(1/40)of patients.Diarhea and neuropathy were generally mild,which weremanageable and reversible.Conclusion:Chrono-chemotherapy of paclitaxol plus cisplatin offers a new treatmentoption providing meaningful tumor control and symptom relief and well-tolerated side effects for advanced non small-cell lung cancer.更多还原