中文摘要：

目的 分析不同含铂双药方案对晚期非小细胞肺癌（NSCLC）患者的疗效及不良反应.方法 以第三军医大学新桥医院呼吸内科2011年1月至2012年12月收治的239例晚期NSCLC患者为研究对象,回顾性分析并比较铂剂分别联合应用紫杉醇（紫杉醇组,113例）、吉西他滨（吉西他滨组,72例）、多西他赛（多西他赛组,54例）的3种方案对患者进行一线治疗的效果及不良反应.采用χ2检验分析疗效及不良反应,采用Kaplan-Meier法进行生存分析.结果 3组患者的客观缓解率分别为42.5%、43.1%、35.2%（P=0.612）,疾病控制率分别为84.1%、75.0%、74.1%（P=0.198）;中位无进展生存期分别为5.6、5.8、3.2个月（P=0.000）.不良反应主要为骨髓抑制、胃肠道反应、脱发和神经毒性等.3种方案神经毒性发生率分别为34.5%（39/113）、11.1%（8/72）、18.5%（10/54）（P=0.001）,其余不良反应发生率差异均无统计学意义（均P〉0.05）.结论 3种含铂方案治疗晚期NSCLC患者均有较好疗效,不良反应可耐受,近期疗效相似;在降低疾病进展风险方面,紫杉醇、吉西他滨方案优于多西他赛方案.

英文摘要：

Objective To explore the efficacies and toxicities of different platinum-based combination chemotherapeutic regiments for patients with advanced non-small cell lung cancer （NSCLC）. Methods A total of 239 advanced NSCLC from January 2011 to December 2012 were reviewed in Xinqiao Hospital. The chemotherapeutic efficacies and adverse effects in the first-line treatment of advanced NSCLC by paclitaxel plus platinum （ paclitaxel group, n = 113 ）, gemcitabine plus platinum （ gemcitabine group, n = 72） and docetaxel plus platinum （docetaxel group, n -＇--54 ） regiments were retrospectively analyzed and compared. Their efficacies and toxicities were analyzed by Chi-square test. And survival was estimated with Kaplan-Meier method. Results The objective response rate （ORR） of three groups were 42. 5 % ,43.1% and 35.2% respectively （P = 0. 612）. The disease control rate （DCR） were 84. 1%, 75.0% and 74. 1% respectively （P = 0. 198）. The median progression-free survival was 5.6,5.8 and 3.2 months respectively （P = 0. 000 ） . The major adverse effects were myelosuppression, gastrointestinal reaction, alopecia and neurotoxicity,etc. The incidence rate of neurotoxicity among three groups were 34. 5% （39/113）, 11.1% （8/72） and 18.5% （10/54） respectively （P = 0. 001 ）. No significant inter-group difference of adverse effects existed （ all P 〉 0. 05 ）, except for neurotoxicity. Conclusions Three platinum-based combination chemotherapeutic regiments produce excellent efficacies with acceptable adverse effects. Their ORR and DCR were similar. And the median progression-free survival of paclitaxel and gemcitabine groups is significantly longer than that of docetaxel group.