2019 年第 4 期 第 14 卷

吉西他滨联合顺铂方案治疗中晚期非小细胞肺癌合并矽肺患者的近期效果和不良反应观察

Short-term efficacy and adverse reactions of gemcitabine plus cis-platinum chemotherapy in moderate and advanced non-small cell lung cancer with silicosis

作者：庞波董明霞李娟邱镞文胡高林李茜胡卓君徐俊

英文作者：

单位：617068四川省攀枝花市第二人民医院职业病科（庞波、董明霞、李娟、邱镞文、胡高林、李茜、胡卓君）；637000四川省南充市中心医院肿瘤科（徐俊）

英文单位：

关键词：非小细胞肺癌；矽肺；吉西他滨；吉非替尼；顺铂

英文关键词：

• 摘要：

• 【摘要】目的    观察吉西他滨联合顺铂方案治疗中晚期非小细胞肺癌合并矽肺患者的近期效果和不良反应。方法    选取四川省攀枝花市第二人民医院2012年1月至2017年6月中晚期非小细胞肺癌合并矽肺患者65例，按照随机数字表法分为对照组（32例）与观察组（33例）。对照组采用吉非替尼联合顺铂方案化疗；观察组采用吉西他滨联合顺铂方案化疗。比较2组近期疗效、临床症状缓解率和缓解时间，以及不良反应情况。结果    观察组和对照组近期总有效率相当［87.9%（29/33）比84.4%（27/32）］，差异无统计学意义（P=0.683）；但观察组客观缓解率明显高于对照组［69.7%（23/33）比43.8%（14/32）］，差异有统计学意义（P=0.035）。观察组咯血、刺激性咳嗽、呼吸困难、胸痛胸闷症状好转时间均明显短于对照组［（4.3±0.3）d比（6.9±1.3）d、（5.0±0.6）d比（11.6±0.9）d、（5.0±2.0）d比（8.0±1.2）d、（7.0±1.6）d比（10.4±1.2）d］（均P＜0.01）。不良反应分级多处于Ⅰ/Ⅱ级。观察组白细胞减少和血小板减少发生率均明显低于对照组（均P＜0.05）。结论    吉西他滨联合顺铂方案治疗中晚期非小细胞肺癌合并矽肺患者的近期效果明显，临床症状缓解快，且用药期间未发生严重的不良反应，安全性较高。

• 【Abstract】Objective    To observe the short-term effect and adverse reaction of gemcitabine plus cis-platinum chemotherapy in the treatment of patients with moderate and advanced non-small cell lung cancer(NSCLC) and silicosis. Methods    A total of 65 NSCLC patients with silicosis were enrolled from January 2012 to June 2017 in the Second People′s Hospital of Panzhihua. The patients were randomly assigned to control group(n＝32) and observation group(n＝33). The control group was treated with gefitinib plus cis-platinum chemotherapy and the observation group was treated with gemcitabine plus cis-platinum chemotherapy. Short-term efficacy, symptomatic remission and adverse reactions were analyzed. Results    Short-term effective rate was equal between observation group and control group［87.9%（29/33） vs 84.4%（27/32）］（P=0.683）. Objective remission rate in observation group was significantly higher than that in control group［69.7%（23/33） vs 43.8%（14/32）］（P=0.035）. Symptom response time of hemoptysis, irritable cough, expiratory dyspnea, chest pain and tightness in observation group were significantly shorter than those in control group［（4.3±0.3）d vs （6.9±1.3）d, （5.0±0.6）d vs （11.6±0.9）d, （5.0±2.0）d vs （8.0±1.2）d, （7.0±1.6）d vs （10.4±1.2）d］（P＜0.01）. Most patients had adverse reactions of stage Ⅰ/Ⅱ. Incidences of leukopenia and thrombocytopenia in observation group were significantly lower than those in control group(P＜0.05). Conclusion    Gemcitabine plus cis-platinum can remarkably increase the short-term effect and relieve clinical symptoms, produces no serious adverse reaction and shows good safety in the treatment of moderate and advanced NSCLC with silicosis.