目的 探讨注射用盐酸吉西他滨联合紫杉醇注射液治疗复发转移性小细胞肺癌的临床疗效。方法 选取2010年1月-2012年12月宝鸡市中医医院收治的、病理组织学确诊且经过一线含铂化疗治疗过的小细胞肺癌患者78例。所有患者随机分为对照组和治疗组,每组各39例。对照组患者静脉滴注紫杉醇注射液80mg/m²,第1天静脉滴注3h。治疗组患者在对照组基础上静脉滴注注射用盐酸吉西他滨1000mg/m²,第1、8天静脉滴注不超过1h。每21天为一个周期,完成2个周期以上化疗且有效者继续进行,完成4个周期化疗者不再维持。随访时间为1~35个月。评价肿瘤化疗疗效和毒性反应,统计患者生存期。结果 治疗后,对照组、治疗组的客观缓解率、疾病控制率分别为12.82%、43.60%,38.46%、56.41%,两组比较差异具有统计学意义(P<0.05)。与对照组比较,治疗组白细胞减少、中性粒细胞减少和血小板减少发生率显著降低(P<0.05)。与对照组比较,治疗组患者的总生存率、无进展生存率差异具有统计学意义(P<0.05)。结论 注射用盐酸吉西他滨联合紫杉醇注射液治疗复发转移性小细胞肺癌具有较好的临床疗效,具有一定的临床推广应用价值。

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.