健择联合卡铂治疗70岁以上进展期非小细胞肺癌患者的观察  

Clinical Observation of Gemcitabine with Carboplatin in Elderly Patients with Advanced Non-small Cell Lung Cancer

作　　者：王海燕[1] 朱正学[2] 肖燕[1] 魏晓阳[1] 谢晓玮[1] 马凌云[1] 文仲光[1] 

机构地区：[1]中国人民解放军总医院第一附属医院呼吸科,北京100037 [2]安庆市枞阳县人民医院内科

出　　处：《肿瘤防治研究》2008年第6期433-435,共3页Cancer Research on Prevention and Treatment

摘　　要：目的观察健择联合卡铂方案治疗70岁以上老年进展期非小细胞肺癌（NSCLC）患者的疗效及副反应，评价该方案的可行性。方法对采用健择联合卡铂化疗的44例进展期NSCLC患者（初治）进行回顾性分析，其中70岁以下24例，70岁以上20例。化疗方案：〈70岁健择1200mg／m^2，d1，8；卡铂AUC=5，d1；≥70岁健择1000mg／m^2，d1，8；卡铂AUC=4，d1。每3周重复，至少治疗2周期，2周后评价疗效。结果70岁以下组共完成89周期化疗，平均3．7周期，有效率（CR＋PR）45．8％，70岁以上组共完成66周期，平均3．3N期，有效率（CR＋PR）40．0％，两组近期有效率比较差异无统计学意义（P〉0．05）。两组在Ⅲ～Ⅳ骨髓抑制、严重恶心呕吐、脱发、肝肾功能损害方面差异无统计学意义（P〉0．05），70岁以下组严重便秘1例，70岁以上组5例，差异有统计学意义（P〈0．05）。两组中分别有2例患者化疗后血小板明显升高，1例56岁男性患者发生双下肢深静脉血栓，抗凝治疗后好转。结论健择联合卡铂化疗治疗70岁以上进展期NSCLC，疗效较好，毒副反应可耐受。Objective To evaluate the effect and toxicity of gemcitabine with carboplatin in elderly patients with advanced non-small cell lung cancer（NSCLC）. Methods Forty-four patients （24 patients less than 70 years old and 20 patients over 70 years old ） received chemotherapy with gemcitabine and carboplatin as follows, gemcitabine （1 200 mg/m^2） iv on day1 and 8, and carboplatin iv on day1, AUC= 5 in patients less than 70 years old; gemcitabine （1 000 mg/m^2 ） iv on dayl and 8, and carboplatin iv on day1, AUC = 4 in patients over 70 years old. At least 2 cycles finished of each patient. Results Eighty-nine cy cles of chemotherapy were completed in patients less than 70 years old, average cycle was 3. 7, the response rate（CR ＋ PR） was 45. 8%. Sixty-six cycles of chemotherapy were completed in patients over 70 years old, average cycle was 3. 3, the response rate（CR ＋ PR）was 40. 0%, the response rate was no significant difference between two groups. The toxicities was no significant difference between two groups such as Ⅲ -Ⅳ bone marrow suppression, severe nausea/vomiting, alopecia, impaired liver toxicity and renal toxicity（P〉0.05）. One patient had severe costive in group of less than 70 years old, and 5 patients in group of over 70 years old, there was significant difference between two groups （P〈0. 05）. After chemotherapy, platelet risen significantly in 2 patients of each group respectively, one patient of 56 years old caught deep venous thrombosis, and he released after accepted antithrombotic therapy. Conclusion The combination of gemcitabine and carboplatin is a feasible, well-tolerated and effective scheme in the treatment of NSCLC patients over 70 years old.

关 键 词：非小细胞肺癌 健择 卡铂 老年患者 

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