The Study About Non-small Cell Lung Cancer Treated By Low-dose Gemcitabine And The Effect On Lung Function

Objective: 1. To evaluate and compare the response and toxicity in advanced non-small-cell lung cancer patients treated by different GP regimen: gemcitabine 6-h prolonged infusion regimen and thirty-minute infusion regimen. 2. To evaluate the effect on lung function of two regimens and compare the lung toxicity in two regimens. Methods : 1. 50 patients with advanced NSCLC are randomly divided into two groups, which accept gemcitabine 6-h prolonged infusion GP regimen(25 case) or thirty-minute infusion GP regimen(25 case) respectively. The response rate, toxicity, 1-year survival rate and TTP (Time to progress) are compared in two group patients. 2. Detection lung function of 30 patients before and after chemotherapy, and comparison two regimens with the effect on lung function. Results :1.The response and toxicity of two group: ①The response rate of 6-h prolonged infusion group is 32%, and the response rate of thirty-minute infusion group is 28%(P>0.05).②The increase rate of KPS has no statistical difference.③Median time to progressive disease are 7.4 months and 7.5 months in 6-h prolonged group and in thirty-minute group(P>0.05); 1-year survival rate are 32% and 28% in 6-h prolonged group and in thirty-minute group(P>0.05).④Hematologic toxicity: neutropenia occur in 60% of patients in 6-h prolonged group and in 64% of patients in thirty-minute infusion group ( P > 0.05 ) ; thrombocytopenia occur in 40% of patients in 6-h prolonged group and in 48% of patients in thirty-minute infusion group (P>0.05). But, grade 3 and 4 neutropenia occur more frequently in thirty-minute infusion group(48%) compared to 6-h prolonged group(20%()P<0.05); grade 3 and 4 thrombocytopenia occur more frequently in thirty-minute infusion group (40%) compared by 6-h prolonged group(12%()P<0.05).⑤Nonhematologic toxicity: There is no statistical difference in nonhematologic between two groups. 2. The effect on lung function ①Lung function change: FEV1/VC show significant increase in two groups patients; TLCO show significant decrease in two groups patients (P<0.01).②The rate of increase of FEV1/VC and the rate of decrease of TLCO in thirty-minute infusion group are higher than the rate of TLCO 6-h in prolonged infusion group(P<0.05). Conclusions: Compared with thirty-minute infusion GP regimen, 6-h prolonged infusion GP regimen has less grade 3 and 4 thrombocytopenia, neutropenia and lung toxicity. 6-h prolonged infusion GP regimen is safe and effective for patients with advanced NSCLC.