150例老年晚期非小细胞肺癌不同治疗方案回顾性分析  

The Retrospective Analysis of Different Therapies on 150 Elderly Patients with Advanced Non-Small Cell Lung Cancer

作　　者：郑积华[1] 张为民[1] 陈海[1] 徐志勇[1] 周娟[1] 谢波[1] 李荔霞[1] 林金容[1] 

机构地区：[1]广州军区广州总医院肿瘤科,广州510010

出　　处：《中国肺癌杂志》2009年第2期122-126,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的老年晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)无标准治疗,本研究比较含铂双药联合化疗、多西他赛单药及最佳支持治疗三种方法治疗老年晚期NSCLC的疗效、毒副作用及中位生存时间,探索老年晚期NSCLC最佳治疗方法。方法回顾性分析2003年3月-2007年3月我院接受含铂双药联合化疗、多西他赛单药化疗及最佳支持治疗(best support care,BSC)三种不同治疗方案的150例老年NSCLC患者。结果含铂双药联合化疗有效率明显较多西他赛单药化疗高,分别为41.2%和20.0%(P<0.05)。含铂双药化疗、多西他赛单药化疗和最佳支持治疗组中位生存期分别为10.7个月、9.2个月和6.3个月,1年生存率分别为39.7%,36.7%和17.3%。化疗组中位生存时间较最佳支持治疗组明显延长(P<0.05),1年生存率较最佳支持治疗组明显提高(P<0.05)。含铂双药化疗和多西他赛单药化疗中位生存期及1年生存率无统计学差异(P>0.05);Ⅲ-Ⅳ度骨髓抑制及消化道毒副作用发生率含铂双药组较多西他赛单药组明显增高(P<0.05)。结论与最佳支持治疗比,化疗能明显延长老年晚期NSCLC中位生存期,提高1年生存率。含铂双药化疗有效率虽较多西他赛单药化疗高,但毒副作用较大,中位生存期及1年生存率无统计学差异,单药化疗应成为老年晚期NSCLC的标准治疗。Background and objective There is still no standard regiment for the treatment of advanced elderly patients with non-small cell lung cancer （NSCLC）. The aim of this study is to explore the best method for the advanced elderly NSCLC patients by analyzing the efficacy and toxicity of cisplatin combined chemotherapy, docetaxel chemotherapy and the best support care （BSC）. Methods One hundred and fifty elderly NSCLC patients （≥ 65 years） with different treatments from March 2003 to March 2007 in our hospital were retrospectively analyzed. Results The objective response rate （ORR） was 41.2% in cisplatin combined chemotherapy, which was significantly higher than 20.0% in docetaxel chemotherapy （P〈0.05）. Median survival time （MST） was 10.7 months, 9.2 months and 6.3 months, and one year survival rate was 39.7%, 36.7% and 17.3%, respectively in cisplatin combined chemotherapy, docetaxel chemotherapy and the best support care. MST was significantly longer （P〈0.05） and one year survival rate was significantly higher （P〈0.05） in the patients with chemotherapy than that with best support care. There was no significant difference of MST and one year survival between cisplatin combined chemotherapy and docetaxel chemotherapy （P〉0.05）. Grade 3-4 toxicity was more serious in cisplatin combined group than that in docetaxel group （P〈0.05）. Conclusion Chemotherapy can prolong the survival time in elderly NSCLC patients. Even though the ORR is higher in cisplatin combined chemotherapy than that in doeetaxel chemotherapy, there was no significant difference of MST and one year survival between cisplatin combined chemotherapy and docetaxel chemotherapy （P〉0.05）, which may due to the more serious toxicity. Docetaxel chemotherapy should be one of the standard regiment for the elderly NSCLC patients.

关 键 词：老年 肺肿瘤 化疗 回顾研究 毒副作用 

分 类 号：R734.2[医药卫生—肿瘤]