目的 探討注射用鹽酸吉西他濱聯(lián)合紫杉醇注射液治療復(fù)發(fā)轉(zhuǎn)移性小細(xì)胞肺癌的臨床療效。方法 選取2010年1月-2012年12月寶雞市中醫(yī)醫(yī)院收治的、病理組織學(xué)確診且經(jīng)過一線含鉑化療治療過的小細(xì)胞肺癌患者78例。所有患者隨機(jī)分為對(duì)照組和治療組,每組各39例。對(duì)照組患者靜脈滴注紫杉醇注射液80mg/m²,第1天靜脈滴注3h。治療組患者在對(duì)照組基礎(chǔ)上靜脈滴注注射用鹽酸吉西他濱1000mg/m²,第1、8天靜脈滴注不超過1h。每21天為一個(gè)周期,完成2個(gè)周期以上化療且有效者繼續(xù)進(jìn)行,完成4個(gè)周期化療者不再維持。隨訪時(shí)間為1~35個(gè)月。評(píng)價(jià)腫瘤化療療效和毒性反應(yīng),統(tǒng)計(jì)患者生存期。結(jié)果 治療后,對(duì)照組、治療組的客觀緩解率、疾病控制率分別為12.82%、43.60%,38.46%、56.41%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。與對(duì)照組比較,治療組白細(xì)胞減少、中性粒細(xì)胞減少和血小板減少發(fā)生率顯著降低(P<0.05)。與對(duì)照組比較,治療組患者的總生存率、無進(jìn)展生存率差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 注射用鹽酸吉西他濱聯(lián)合紫杉醇注射液治療復(fù)發(fā)轉(zhuǎn)移性小細(xì)胞肺癌具有較好的臨床療效,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To discuss the clinical effect of Gemcitabine Hydrochloride for injection combined with Paclitarel Injection in treatment of recurrent and metastatic small cell lung cancer. Methods Patients (78 cases) with recurrent and metastatic small cell lung cancer received platinum-containing first-line chemotherapy in Baoji Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were randomly divided into control and treatment groups, and each group had 39 cases. The patients in the control group were iv administered with Paclitarel Injection 80 mg/m², given during 3 h in the first day. The patients in the treatment group were iv administered with Gemcitabine Hydrochloride for injection on the basis of the control group, the dosage of 1 000 mg/m² were given within 1 h on days 1 and 8. Each cycle had 21 d. Patients were treated for two cycles, and then given no more than four cycles of treatment. Follow up time were 1 to 35 months. After treatment, the efficacy and toxicity reaction were evaluated, and survivals were calculated. Results After treatment, the objective response rate of control group was 12.82%, and the clinical control rate was 43.60%, while the objective response rate of treatment group was 38.46%, and the clinical control rate was 56.41%, and there were differences between two groups (P < 0.05). Compared with the control group, incidences of white blood cells reduce, neutrophils reduce, and thrombocytopenia reduce in the treatment group were significantly decreased (P < 0.05). There were differences of total survival rate and progression free survival rate between two groups (P < 0.05). Conclusion Gemcitabine Hydrochloride for injection combined with Paclitarel Injection has good clinical effect in treatment of recurrent and metastatic small cell lung cancer, which has a certain clinical application value.