目的 比较不同剂量顺铂联合吉西他滨治疗非小细胞肺癌的临床疗效。方法 选取2016年2月-2018年2月复旦大学附属中山医院青浦分院收治的150例非小细胞肺癌患者为研究对象，按照化疗药物剂量不同，将150例患者随机平均分为A、B、C三组，每组各50例。A组患者第1~5天每天连续静脉输入15 mg/m²顺铂注射液；B组患者第1~3天每天连续静脉输入25 mg/m²顺铂注射液；C组患者仅第1天静脉输入80 mg/m²顺铂注射液，3组患者均在第1天、第8天和第15天输入1 g/m²注射用盐酸吉西他滨，每4周为1个疗程，共治疗4个疗程。观察3组患者的临床疗效，比较3组治疗前后血清CYFRA21-1、SCC-Ag、生活质量评分的变化情况。结果 治疗后，3组总有效率分别是32.0%、34.0%、38.0%，3组患者的总有效率比较差异无统计学意义。治疗后，3组患者CYFRA21-1、SCC-Ag水平均显著下降（P<0.05），但3组患者之间比较差异无统计学意义。化疗结束1周后，B组评分略有升高或降低，C组患者评分均有所下降，但A组患者的评分有所提升（P<0.05）；治疗后B、C两组生活质量评分和A组相比差异有统计学意义（P<0.05）。结论 低剂量顺铂联合吉西他滨治疗非小细胞肺癌有较好的临床疗效，可改善患者生活质量，小剂量顺铂连续给药可降低患者化疗的毒副反应，具有一定的临床推广应用价值。

Objective To compare the clinical efficacy of different dosages of cisplatin combined with gemcitabine in treatment of non-small cell lung cancer. Methods A total of 150 patients with non-small cell lung cancer admitted to Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from February 2016 to February 2018 were selected as research objects. According to different dosages of chemotherapy drugs, the 150 patients were randomly divided into A, B and C groups, with 50 patients in each group. Patients in group A were iv administered with 15 mg/m² Cisplatin Injection intravenously for 1 to 5 days. Patients in group B iv administered with 25 mg/m² Cisplatin Injection intravenously for 1 to 3 days. Patients in group C were iv administered with 80 mg/m² Cisplatin Injection only on the first day, and patients in the 3 groups were given 1 g/m² Gemcitabine Hydrochloride for injection on the 1st, 8th and 15th days. Every 4 weeks was a course of treatment, and the patients received 4 courses of treatment. The clinical efficacy of the three groups was observed, and the changes of serum CYFRA21-1, SCC-AG and life quality scores before and after treatment were compared. Results After treatment, the total effective rate of the three groups was 32.0%, 34.0%, and 38.0%, respectively, and the difference of the total effective rate among three groups was not statistically significant. After treatment, CYFRA21-1 and SCC-AG levels in the three groups were significantly decreased (P<0.05), but there was no statistically significant difference among three groups. One week after the end of chemotherapy, the life quality score of group B was slightly increased or decreased, while those of group C were decreased, but those scores of group A were improved (P<0.05). There were statistically significant differences in life quality scores among group B and Group C after treatment compared with group A (P<0.05). Conclusion Low dosage cisplatin combined with gemcitabine has good clinical efficacy in treatment of non-small cell lung cancer, and can improve the life quality of patients, and continuous administration of low dosage cisplatin can reduce the toxic and side effects of chemotherapy, which has certain clinical application value.

R978

上海市科技计划项目（QKY2018-15）