健择与顺铂联合紫杉醇治疗高龄非小细胞肺癌患者的临床研究  

Single Gemcitabine Compared with Cisplatin Plus Paclitaxel for Elderly Patients with NSCLC

作　　者：姚兵[1] 杜小波[1] 李慧[1] 李雪松[1] 冯刚[1] 王晋[1] 

机构地区：[1]四川省绵阳市中心医院肿瘤科,四川绵阳621000

出　　处：《四川肿瘤防治》2007年第2期117-120,共4页Sichuan Journal of Cancer Control

摘　　要：目的：评价单药健择与低剂量顺铂联合紫杉醇方案治疗高龄晚期非小细胞肺癌（NSCLC）患者的临床疗效与不良反应。方法：回顾性收集了我院1999年1月～2005年9月治疗的38例ⅢB／Ⅳ期高龄晚期非小细胞肺癌患者的临床资料，其中健择单药病人组（GEM组，n=18）及低剂量顺铂联合紫杉醇化疗病人组（PC组，n=20），对两组疗效及副作用进行分析。结果：老年晚期非小细胞肺癌GEM组治疗有效率为11．1％（2／18），PC治疗组为20％（4／20），无显著差异（P=0．66）。GEM组中位生存期为5．3个月，1年生存率为16．7％；PC组中位生存期为6．1个月，1年生存率为25％，无显著差异（P=0．70）。联合治疗组不良反应率较单药组高。结论：该两个方案都是治疗高龄晚期NSCLC患者的有效方案。联合化疗方案虽然在疗效上略高于健择单药化疗方案，却增加了一定的毒副反应；单药健择化疗对于高龄ⅢB／Ⅳ期NSCLC患者不失为一种好的姑息性化疗方案。该两个方案对比有待进一步扩大样本量临床随机对照研究。Objective： To compare the clinical efficacy and adverse effects of elderly patients with NSCLC treated with single gemcitabine （GEM） chemotherapy and combined chemotherapy of low does cisplatin plus paclitaxel. Methods： A retrospective study was performed in 38 elderly patients with with stage ⅢB/Ⅳ NSCLC who were treated in our hospital from 1999.1 to 2005.9. The single agent group included 18 patients , received gemcitabine 1000 mg/m^2 on day 1 ,8 ,15 and the combined group included 20 patients , received paclitaxel 135mg/m^2 - 175 mg/m^2 on day 1, DDP 40 mg/m^2 on day 1 and administered every 3 weeks. Their clinical features, management and outcome were analysed. Results： The response rate of single group was 11.1% （ 2/18）, 2 PR, and the response rate of the combined group was 20 % （4/20）, 1CR and 3 PR. Median survival time was 5.3 months for patients treated with gemcitabine and 6.1 months for those treated with combined chemotherapy. One-year survival rates were 16.7% and 25% respectively. According to occurrence rate of adverse effects, the combined group was higher than the single agent group. Conclusion： This study confirms the activity of the single-agent gemcitabine and combined chemotherapy in elderly patients with advanced NSCLC. Single-agent chemotherapy （gemcitabine） could be the preferred option, although low-dose eisplatin-based combined chemotherapy may represent alternative option. Further studies are needed to establish the place of chemotherapy in elderly patients with advanced NSCLC.

关 键 词：高龄患者 非小细胞肺癌 健择 联合化疗 

分 类 号：R734.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]