胰岛素对复治非小细胞肺癌患者化疗增效作用的临床研究

摘要

Objective To observe the synergistic effect of insulin on chemotherapy in retreatment non-small cell long cancer patients. Method 50 cases of retreatment non-small cell long cancer patients were divided into insulin synergistic group(26 cases) and control group(24 cases). Insulin 0.4U/kg in 10% glucose injection 1000ml intravenous drip before chemotherapy 10 hours in insulin synergistic group, cisplatin 80mg/m2 was given by intravenous infusion divided into 3 or 5 days or carboplatin 300mg/m2 was given by intravenous infusion on 1st day, vinorelbine 250mg/m2 in 100ml normal saline on 1st and 8th days or paclitaxel 150mg/m2 in 3h on 1st day or gemcitabine 1000mg/m2 in 100 ml normal saline in 30 minute on 1st and 8th days in two groups, 3 weeks was one cycle, each case completed with at least 2 cycles. Result The overall response rate in the insulin synergistic group was 50.0%, 13 patients achieved partial response, 6 patients stable disease, 7 patients progression disease.The overall response rate in the control group was 20.8%, 5 patients achieved partial response, 9 patients stable disease, 10 patients progression disease.There was a significant response difference checked by χ2 test between two groups(χ2=3.920, P=0.048). 1 year survival rate was higher in insulin synergistic group(10/26, 38.5%) than in control group (8/24, 33.3%; χ2=3.920, P=0.048). Conclusion There was certain synergistic effect of insulin on chemotherapy in retreatment non-small cell long cancer patients, and their life span was extended.%目的：观察胰岛素对复治非小细胞肺癌患者的化疗增效作用。方法将本院2007年10月至2010年6月50例复治非小细胞肺癌患者随机分为胰岛素增效组（26例）及对照组（24例），胰岛素增效组于化疗前10小时应用胰岛素0.4U/kg加于10%葡萄糖注射液1000ml中静脉滴注；顺铂80mg/m2分别于第3～5天静脉滴注或第1天卡铂500mg静脉滴注，第1天及第8天长春瑞滨25mg/m2加于生理盐水100ml中静脉滴注，或第1天紫杉醇150mg/m2静脉滴注3小时，或第1天及第8天吉西他滨1000mg/m2加于生理盐水100ml中静脉滴注30分钟；对照组仅用“长春瑞滨、顺铂或卡铂”或“紫杉醇、顺铂或卡铂”或“吉西他滨、顺铂或卡铂”方案化疗，化疗药物用法及剂量同胰岛素增效组。21天为1个周期，两组均治疗2个周期以上。结果胰岛素增效组部分缓解13例、稳定6例、进展7例，有效率为50.0%，对照组部分缓解5例、稳定9例、进展10例，有效率为20.8%，两组有效率差异有显著性（χ2=3.920，P=0.048）。胰岛素增效组1年生存率为38.5%（10/26），高于对照组的33.3%（8/24），差异有显著性（χ2=3.920， P=0.048）。结论胰岛素对复治非小细胞肺癌患者化疗具有一定增效作用，可延长生存。