摘要
目的评价老年晚期非小细胞肺癌(NSCLC)患者接受以铂类为基础的两药联合化疗的疗效及安全性。方法回顾性分析2003年1月至2009年12月北京胸科医院肿瘤内科收治的晚期NSCLC患者115例,年龄≥65岁,均接受以铂类为基础的两药联合一线化疗。具体化疗方案为:顺铂50～60mg/m2或卡铂曲线下面积(AUC)4～5静滴,第1天;紫杉醇135～150mg/m2静滴3～4h,第1天;或长春瑞滨25mg/m2静滴6～10min,第1、8天;或吉西他滨1000mg/m2静滴30min,第1、8天。上述方案3～4周为1个周期。观察并随访治疗疗效及主要不良反应。结果 115例患者中,应用铂类联合紫杉醇方案化疗44例(38.3%),联合吉西他滨方案31例(27.0%),联合长春瑞滨方案40例(34.7%)。全组患者的有效率(RR)为26.1%,疾病控制率(DCR)为76.5%,中位无进展生存时间(PFS)为5.5个月,中位总生存时间(OS)为14.0个月,1、2年生存率分别为50%和15%。化疗相关不良反应主要为骨髓抑制,包括白细胞及血小板减少,对症处理后可恢复。按照不同年龄、方案、铂类药物及ECOG评分进行亚组分析,其中不同ECOG评分及铂类药物的中位PFS及OS差异有统计学意义(P<0.05)。结论以铂类为基础联合第3代细胞毒性药物的两药方案一线治疗一般状态较好的老年晚期NSCLC的疗效较好,毒副反应可以耐受。
Objective To evaluate the efficacy and safety of platinum-based chemotherapy in elderly patients with advanced non-small cell lung cancer（NSCLC）.Methods Clinical data of elderly patients（≥65 years） with advanced NSCLC who were treated by platinum-based chemotherapy were analyzed retrospectively.Cisplatin 50-60 mg/m2 or carboplatin（AUC=4-5） d1,paclitaxel 135-150mg/m2 d1or vinorelbine 25mg/m2d1,d8or gemcitabine 1000mg/m2d1,d8,was administered intravenously with a 3-4 weeks cycle.Results Among the patients,44（38.3%） patients were treated with paclitaxel,31（27.0%）patients with gemcitabine,40（34.7%） patients with vinorelbine,respectivety.The overall response rate was 26.1% and disease control rate was 76.5%.The median progression free survival（PFS）was 5.5 months and median overall survival（OS） was 14.0 months.1-,2-year survival rates were 50% and 15% respectively.The major side effect was bone marrow suppression,especially neutropenia and thrombocytopenia.The adverse events were manageable.There was a trend towards an increase in PFS and OS,which reached statistical significance in ECOG and platinum subgroups（P〈0.05）.Conclusion The platinum-based combined chemotherapy is effective and well tolerated in elderly patients with advanced NSCLC.
出处
《临床肿瘤学杂志》
CAS
2012年第7期634-638,共5页
Chinese Clinical Oncology
关键词
非小细胞肺癌
老年
铂类化疗
Non-small cell lung cancer（NSCLC）
Elderly
Platinum-based chemotherapy
作者简介
通讯作者，E—mail：zhangshucai6304@yahoo．com.cn
