【摘要】 目的比较长春瑞滨(NVB)联合替吉奥(S-1)或顺铂治疗进展期非小细胞(NSCLC)的临床疗效及不良反应。方法选择进展期NSCLC患者80例,随机分为观察组和对照组。观察组采用NVB联合S-1方案:S-1 200 mg/m2(体表面积≤1. 25 m2)或300 mg/m~2(体表面积> 1. 25 m2),d2~d6、d9~d13; NVB 25 mg/m2静脉滴注,d1、d8。对照组采用NP方案:NVB 20 mg/m2静脉滴注,d1、d8;顺铂30 mg/m~2,d1~d3。比较2组短期疗效、KPS评分,比较化疗后患者生活质量以及不良反应,分析患者治疗前后血清环氧合酶2(COX-2)和基质金属蛋白酶9(MMP-9)的变化。结果观察组有效率(ORR)和疾病控制率(DCR)分别45. 0%和77. 5%,对照组为40. 0%和65. 0%,2组间治疗效果无明显差异。化疗后观察组患者生活质量优于对照组(P <0. 05),严重不良反应发生率明显低于对照组(P <0. 05)。化疗可降低患者血清COX-2和MMP-9水平,观察组患者改善效果更明显(P <0. 05),且化疗后患者COX-2和MMP-9水平随着治疗效果下降而升高。结论 NVB联合S-1治疗进展期NSCLC与NP方案比较,疗效无明显差异,但NVB联合S-1化疗后患者生活质量更高,毒副作用小。COX-2和MMP-9水平可作为预测和反映化疗效果的指标。更多还原

【Abstract】 Objective To compare the clinical and side effect of vinorelbine( NVB) combined with S-1 or cisplatin in the treatment of advanced none-small lung carcinoma( NSCLC). Methods 80 patients with NSCLC were randomly divided into the observation group and the control group. The observation group was treated with NVB combined with S-1 program: S-1 200 mg/m~2( body surface area less ≤1. 25 m2) or 300 mg/m~2( body surface area > 1. 25 m2),d2~ d6,d9~ d13,NVB 25 mg/m~2 vein Infusion,d1,d8; control group using NP program: NVB 20 mg/m~2 intravenous infusion,d1,d8,cisplatin 30 mg/m2,d1~ d3. Comparison the short-term efficacy,life quality and adverse reactions after chemotherapy. Results The Overall Response Rate( ORR)and disease control rate( DCR) were 45. 0% and 77. 5% in the observation group,40. 0% and 65. 0% in the control group. The live quality was higher and adverse reaction was lower of the observation group than control group. Chemotherapy reduced the serum levels of COX-2 and MMP-9,which in the observation group was more obvious( P < 0. 05). Conclusion NVB combined with S-1 treatment of advanced NSCLC has the same treatment effect to NP programe,but NVB combined with S-1 patients with higher quality of life and lower side effects after chemotherapy. COX-2 and MMP-9 levels can be used as indicators to predict and reflect the efficacy of chemotherapy.更多还原