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目的 探讨顺铂与吉西他滨联合化学治疗对中晚期非小细胞肺癌患者的影响.方法 选取2014年3月至2015年3月山东省滨州市中心医院肿瘤科收治的86例中晚期非小细胞肺癌患者,采用随机数表法将其随机分为两组,吉非替尼联合治疗组患者43例,男23例,女20例,年龄(58. 7 ± 10. 93)岁,年龄范围为44~73岁,吉西他滨联合治疗组患者43例,男25例,女18例,年龄(61. 8 ± 7. 44)岁,年龄范围为46~72岁.吉非替尼联合治疗组采用顺铂联合吉非替尼化学治疗,吉西他滨联合治疗组采用吉西他滨联合顺铂化学治疗,比较两组患者的临床治疗效果、不良反应发生率及随访3年复发率、转移率、生存率以及生活质量.结果 吉西他滨联合治疗组患者总有效率[86. 1% (37/43)]高于吉非替尼联合治疗组患者[69. 8% (30/43)],吉西他滨联合治疗组患者不良反应发生率[6. 9% (3/43)]低于吉非替尼联合治疗组患者[18. 4% (8/43)],差异均有统计学意义(P<0. 05).吉西他滨联合治疗组患者复发率与转移率[4. 6% (2/43)、2. 3% (1/43)]均低于吉非替尼联合治疗组患者[ 16. 3% ( 7/43)、14. 0% ( 6/43)],吉西他滨联合治疗组患者生存率[55. 8% (24/43)]高于吉非替尼联合治疗组患者[34. 9% (15/43)],吉西他滨联合治疗组患者平均生存时间(22. 23 ± 1. 24)个月长于吉非替尼联合治疗组患者(18. 23 ± 1. 34)个月,差异均有统计学意义(P<0. 05).吉西他滨联合治疗组患者随访期间的生理、日常生活、认知、情感、社会功能及总体健康状况评分均高于吉非替尼联合治疗组患者,差异有统计学意义(P<0. 05).结论 在中晚期非小细胞肺癌的治疗过程当中,顺铂与吉西他滨联合化学治疗对中晚期非小细胞肺癌的治疗效果更加显著,在随访期间生存率较高,且治疗期间不会增加化学治疗的不良反应,安全性较高.

Objective To investigate the 3-year survival rate of patients with advanced non-small cell lung cancer who received cisplatin combined with gemcitabine chemotherapy. Methods A retrospec-tive study was performed on 86 cases of patients with advanced non-small cell lung cancer who were admit-ted from March 2014 to March 2015. Patients were randomly divided into the gefitinib combined treatment group,43 cases,including 23 male and 20 female,aged(58. 7 ± 10. 93) years old,ranged from 44 to 73 years old; the gemcitabine combined treatment group,43 cases, including 25 male and 18 female, aged (61. 8 ± 7. 44)years old,ranged from 46 to 72 years old. The gemcitinib combined treatment group of pa-tients was treated with cisplatin combined chemotherapy,and the gemcitabine combined treatment group was treated with gemcitabine combined cisplatin chemotherapy. The clinical efficacy,incidence of adverse reac-tions,recurrence rate,metastasis rate,survival rate and quality of life of the patients in the two groups were compared. Results The total effective rate[86. 1% (37/43)]in the gemcitabine combined treatment group was higher than that in the gemcitabine combined treatment group[69. 8% (30/43)],and the incidence of adverse reactions [6. 9% (3/43)] in the gemcitabine combined treatment group was lower than that in the gemcitabine combined treatment group [18. 4% ( 8/43 )], with statistically significant differences ( P <0. 05). The recurrence rate and metastasis rate of patients in the gemcitabine combined treatment group [4. 6% (2/43),2. 3% (1/43)] were lower than those in the gemcitabine combined treatment group [16. 3% (7/43),14. 0% (6/43)];the survival rate [55. 8% (24/43)] in the gemcitabine combination treatment group was higher than that in the gemcitabine combination treatment group [34. 9% (15/43)];the mean survival time(22. 23 ± 1. 24)months in the gemcitabine combined treatment group was longer than that in the gemcitabine combined treatment group(18. 23 ± 1. 34)months,and the difference was statistical-ly significant(P<0. 05). The scores of physiology,daily life,cognition,emotion,social function and overall health status in the gemcitabine combined treatment group were all higher than those in the gemcitabine combined treatment group during the follow-up period,and the differences were statistically significant(P<0. 05). Conclusion Cisplatin combined with gefitinib in the treatment of advanced NSCLC is more effec-tive,which can achieve better survival rate during the follow-up,and the side effects of chemotherapy will not be increased during the treatment,so the safety is higher.