长春瑞滨单药及联合卡铂治疗初治的老年人中晚期非小细胞肺癌  

Clinical study on chemotherapy of vinorelbine versus vinorelbine plus carboplatin in elderly patients with advanced non-small cell lung cancer

作　　者：娄广媛[1] 李铁[1] 古翠萍[1] 洪丹[1] 陈金麟[1] 张沂平[1] 

机构地区：[1]浙江省肿瘤医院化疗中心,杭州310022

出　　处：《中华老年医学杂志》2009年第3期199-201,共3页Chinese Journal of Geriatrics

摘　　要：目的观察长春瑞滨单药及长春瑞滨联合卡铂治疗初治的65岁及以上非小细胞肺癌（NSCLC）患者的疗效、毒副反应、生存时间和生活质量，探讨适合中晚期老年非小细胞肺癌的化疗方案。方法65岁及以上Ⅲ9期和Ⅳ期老年非小细胞肺癌患者80例，随机分为长春瑞滨单药治疗组和长春瑞滨联合卡铂治疗联合组。单药组长春瑞滨25mg／m^2。第1天及第8天静脉滴注。每21天为1个周期。联合组长春瑞滨25mg／m^2第1天及第8天静脉滴注，卡铂AUC5第1天静脉滴入。每21天为1个周期。结果单药组有效率35．0％，中位生存时间9．0个月，1年生存率35．0％；联合组有效率42．5％，中位生存时间10．0个月，1年生存率37．5％，两组差异无统计学意义（X^2=0．296，P=0．586）。化疗后联合组的3～4度粒细胞减少（X^2=7．168，P=0．014）、3～4度血小板减少（X^2=5．165，P=0．048）及3～4度恶心呕吐（X^2=6．275，P=0．025）显著高于单药组。治疗后长春瑞滨单药组的缺乏食欲（X^2=2．600，P=0．011）、乏力（X^2=3．169，P=0．002）及疼痛评分（X^2=2．257，P=0．027）高于联合组，两组比较差异有统计学意义。结论长春瑞滨单药是更适宜老年人中晚期NSCLS的化疗方案。Objective To observe the efficacy,toxic side effects, survival time and quality of life （QOL） of vinorelbine and vinorelbine plus carboplatin in elderly patients with stage Ⅲ b/Ⅳ non-small cell lung cancer（NSCLC）. Methods Eighty patients aged 65 years or over with stage I]I b/iV nonsmall cell lung cancer were randomly divided into two groups. One group was treated with vinorelbine （vinorelbine 25 mg/m^2 iv dl, 8, repeated every 21 days）, the other group was treated with vinorelbine plus carboplatin（vinorelbine 25 mg/m^2 iv at day 1 and 8 and carboplatin AUC5 iv at day 1, repeated every 21 days）. Results The response rate（RR）, median survival time（MST） and 1-year survival rate were 35.0%, 9.0 months and 35.0% in vinorelbine group and were 42.5%, 10.0 months and 37.5% in vinorelbine plus carboplatin group respectively. There was no significant difference between two groups （x^= 0.296, P = 0.586）. The incidences of Ⅲ- Ⅳdegree granulocytopenia （x^2 = 7.168, P = 0. 014）, Ⅲ- Ⅳ degree thrombocytopenia （X^2 =5. 165 ,P=0. 048）and Ⅲ- Ⅳ degree nausea and vomiting （x^2 =6. 275, P = 0. 025） were significantly higher in the combined chemotherapy group than in the vinorelbine treatment group. The scores of lung cancer symptom scale （LCSS） of appetite loss（x^= 2. 600,P=0.0.11）, fatigue（x^2 =3. 169,P=0. 002） and pain（x^2 =2. 257,P=0. 027） were more higher in the vinorelbine treatment group than in the combined chemotherapy group. Conclusions Vinorelbine regimen is effective, well tolerated and more favorable for the elderly NSCLC patients.

关 键 词：癌 非小细胞肺 抗肿瘤联合化疗方案 吲哚生物碱类 铂化合物 

分 类 号：R686[医药卫生—骨科学]