Background and objective: Chemotherapy has become the mainstay of first-line therapy. Non-platinum containing drugs are characterized by favorable toxicity profiles and is better tolerated than platinum-based regimens. The aim of this study is to detect the efficacy and toxicity of gemcitabine and vinorelbine (GN) in advanced non-small cell lung cancer (NSCLC) first-line treatment in China.
Methods: We retrospectively reviewed 67 NSCLC patients treated with this agent at five Hospital in China from Jan 2004 to Jun 2010. Survival analysis was evaluated by Kaplan-Meier method, multivariate analyses were performed to find prognostic markers using Cox proportional hazards model.
Results: A total of 67 patients were analyzed in this study. There were 52 patients with RRM1 negative and ERCC1 positive. The objective response rate was 34.3%. The disease control rate was 76.1%. The progression-free survival and median overall survival was 5.5 and 22.1 months, respectively. On multivariate analysis, performance status score and whether further treatment were independent prognostic factor for overall survival.
Conclusion: The GN agent is effective for the first line treatment in advanced non-small cell lung cacer. The toxicity is well tolerated.
背景与目的: 化疗是目前晚期非小细胞肺癌主要的治疗手段，非铂两药方案因避免了严重的肝肾毒性，成为常见的治疗选择。本研究回顾性分析晚期非小细胞肺癌一线使用吉西他滨+长春瑞滨（GN）方案的患者，探讨该方案的疗效和安全性。
方法: 通过非干预的方式收集国内5家医院在2004年1月1日-2010年6月30日行GN方案一线治疗的晚期非小细胞肺癌患者，统计患者的疗效及毒副反应。应用Kaplan-Meier法进行生存分析，Cox方法对影响患者疗效的年龄、性别、分期、病理类型等进行多因素分析。
结果: 共67例患者采用了GN方案，52例为RRM1阴性和ERCC1阳性患者，其余15例患者未行RRM1和ERCC1测定。其一线治疗的客观缓解率为34.3%，疾病控制率为76.1%，中位无进展生存期为5.5个月，中位总生存期为22.1个月，多数患者的毒副反应可以耐受。体能状况评分、是否后续治疗对患者的生存期有明显影响。
结论: GN方案在晚期非小细胞肺癌一线治疗中有较好的疗效和安全性。