肺癌化疗方案..docxVIP

肺癌化疗方案非小细胞肺癌化疗原则: ·尽管同时化疗和放疗，但是数据支持全剂量的顺铂方案优于含卡珀方案;卡铂方案没有充分测试。1 ·治疗晚期病人原则 :1?? 含铂类化疗方案延长了生存率，提高了症状控制率，与最好支持性护理可得到更好的生活质量。 ? ?没有具体含铂化疗方案的细胞毒性明显优于另一组化疗方案。? ?患者年龄的病人生活质量评分3或4, 都不能从细胞毒性化疗中获益，而由表皮生长受体(EGFR)突变阳性病人接受（erlotinib）埃罗替尼能获益。非小细胞肺癌辅助性化疗1. Cisplatin (Platinol; CDDP) + vinorelbine (Navelbine)1–4 Days 1 and 8: Cisplatin 50mg/m2 IV, plus? Days 1, 8, 15 and 22: Vinorelbine 25mg/m2 IV. Repeat cycle every 4 weeks for 4 cycles. 或者Day 1: Cisplatin 100mg/m2 IV, plus Days 1, 8, 15 and 22: Vinorelbine 30mg/m2 IV. Repeat cycle every 4 weeks for 4 cycles. 2. Cisplatin + etoposide (Toposar, VePesid, Etopophos; VP-16)1, 3 Day 1: Cisplatin 100mg/m2 IV, plus Days 1–3: Etoposide 100mg/m2 IV. Repeat cycle every 4 weeks for 4 cycles. 3. Cisplatin + vinblastine (Velban)1,3 Days 1: Cisplatin 80mg/m2 IV.?Repeat cycle every 3 weeks for 4 cycles.?Days 1, 8, 15 and 22: Vinblastine 4mg/m2 IV, then every 2 weeks after Day 43 until last cisplatin administration. 4. Cisplatin + gemcitabine (Gemzar)1 Day 1: Cisplatin 75mg/m2 IV, plus?Days 1 and 8: Gemcitabine 1,250mg/m2 IV. Repeat cycle every 3 weeks. 5. Cisplatin + docetaxel (Taxotere)1,5 Day 1: Docetaxel 75mg/m2 IV + cisplatin 75mg/m2 IV. Repeat cycle every 3 weeks. 6. Cisplatin + pemetrexed (Alimta)1 Day 1: Cisplatin 75mg/m2 IV + pemetrexed 500mg/m2 IV. Repeat cycle every 3 weeks for 4 cycles. (For adenocarcinoma and large cell carcinoma and NSCLC NOS without specific histologic subtype) 7. Paclitaxel (Taxol) + carboplatin (Paraplatin)1,6 Day 1: Paclitaxel 200mg/m2 IV + carboplatin AUC=6mg/mL/min IV. Repeat cycle every 3 weeks for 4 cycles. 同时化放疗方案Cisplatin + etoposide1,7 Days 1, 8, 29 and 36: Cisplatin 50mg/m2 IV, plus?Days 1–5 and 29–33: Etoposide 50mg/m2 IV, plus? Concurrent thoracic RT 1.8Gy/day for 5 days/week (total dose, 61Gy); preferred regimen. Cisplatin + vinblastine1,8 Days 1 and 29: Cisplatin 100mg/m2 IV, plus?Days 1, 8, 15, 22 and 29: Vinblastine 5mg/m2 IV.?Concurrent thoracic RT (total dose, 60Gy); preferred regimen. 序惯化放疗Cispl