Clinical Comparative Investigation Of Efficacy And Toxicity Of Cisplatin Plus Gemcitabine Or Plus Abraxane As First-line Chemoth Erapy For Advanced Non-small Cell Lung Cancer

Lung cancer is one of the most common malignant tumor,in which non-small cell lung cancer(NSCLC)accounts for about 80 to 85%.With poor sensitivity to chemotherapy,the remission rate is only 15% to 20% in the 70 s,and the average5-year survival rate for NSCLC patients is only 15%.In recent ten years,the curative effect of chemotherapy increased significantly and the remission rate has climbed to40% because of the new effective anticancer drugs increased continuously and the new schemes increase in quantity and quality.Chemotherapy is one of the most important treatment method,especially for advanced non-small cell lung cancer.Cisplatin plus Gemcitabine(GP regimen)or plus Paclitaxel(TP regimen)are recognized as standard chemotherapy regimen for advanced non-small cell lung cance.Abraxane is a new kind of Paclitaxel with better curative effect and fewer side effects.Thus Cisplatin plus Abraxane is also recognized as common chemotherapy regimen for advanced non-small cell lung cancer.There are a lot of reports about the clinical observations have shown significant efficacy of Cisplatin plus Gemcitabine(GP regimen)or plus Abraxane(TP regimen)for treating advanced non-small cell lung cancer.But it is rare about the comparison of two groups at home and abroad.By a clinical comparative investigation of efficacy and toxicity of two rigimems,we found that the efficacy of cisplatin in combination with abraxane in the treatment is better than with gemcitabine and it has less risk of hematology toxicity.Objective At present,there is little research about the comparison of Cisplatin plus Gemcitabine or plus Abraxane.So we designed a retrospective study to compare the efficacy and adverse reactions of these two regimes as the first-line therapy for advanced non-small cell lung cancer patients.and we also analysed the comparison in squamous carcinoma between the two regimems and in adenocarcinoma carcinoma.The goal of the retrospective study is to evaluate the efficacy and safety of therapy for advanced non-small cell lung cancer,and provide some useful references for the further therapy.Methods We retrospectively analyzed 46 cases of untreated advanced non-small cell lung cancer patients(clinical stage IV)as group GP,who had been treated with Cisplatin plus Gemcitabine in Shandong Tumor Hospital from May 2012 to October 2015.And we also analyzed 42 cases of untreated advanced non-small cell lung cancer patients(clinical stage IV)as group TP,who had been treated with Cisplatin plus Abraxane.GP group: gemcitabine was used at a dose of 1000mg/m2 on day1 and day8,cisplatin was administered on day 1-3 of each course at a dose of 75mg/m2.They were added to the 250 ml saline respectively,and used by the method of intravenous drip(iv).TP group: abraxane was used at a dose of 240mg/m2 on day1,cisplatin was administered on day 1-3 of each course at a dose of 75mg/m2.They were added to the 250 ml saline respectively,and used by the method of intravenous drip(iv).21 days for one circle,at least two cycles were completed in each group.The content of analysis included response rate(RR),disease control rate(DCR),progression free survival(PFS)and treatment-related adverse reactions of patients of two groups.All statistics were completed with SPSS17.0 software,the rate of the comparison was analyzed by chi-square test or Fisher’s exact test;progression free survival was analyzed by Kaplan-Meie method,the difference between two groups was analyzed by Log-rank test;the difference was statistically significant(P<0.05).Results1.Efficacy: Of all patients :RR was 30.4%,DCR was 63.0%,median PFS was5.9 months in group GP;RR was 33.3%,DCR was 69.0%,median PFS was 6.4months in group TP.After statistical analysis,there was no significant difference in RR,DSR and PFS(P>0.05).2.Adverse reaction: The common treatment related adverse events were hematology toxicity and gastrointestinal reaction.Hematology toxicity mainly included white blood cells and platelets all decreased,the differences between the two groups had statistical sense(P<0.05).Gastrointestinal reaction mainly included nausea and vomiting,there was no statistical significance between them(p= 0.883).3.Of all patients with squamous carcinoma in GP group: RR was 36.4%,DCR was 63.6%,median PFS was 6.2 months.In TP group : RR was 42.8%,DCR was71.4%,median PFS was 6.5 months.There was no significant difference in RR,DSR and PFS(P>0.05);4.Of all patients with adenocarcinoma carcinoma in GP group: RR was 31.4%,DCR was 62.9%,median PFS was 5.2 months.In TP group: RR was 32.1%,DCR was 67.9%,median PFS was 6.5 months.There was no significant difference in RR,DSR and PFS(P>0.05).Conclusions1.The efficacy of cisplatin in combination with abraxane in the treatment is better than with gemcitabine but it has no statistical significance.2.Cisplatin in combination with abraxane in the treatment has less risk of hematology toxicity3.The efficacy of cisplatin in combination with abraxane in the treatment of squamous carcinoma or adenocarcinoma carcinoma is equal to with gemcitabine,it has no statistical significance.