最佳支持治疗与吉西他滨或并卡铂治疗老年晚期非小细胞肺癌的临床比较  

Best supportive care,single agent chemotherapy with gemcitabine and gemcitabine plus carboplatin in the treatment of advanced non-small-cell lung cancer in the aged

作　　者：张建华[1] 黄建国[1] 朱斌[1] 张雯[1] 王爱玲[1] 

机构地区：[1]江苏省沛县人民医院肿瘤科,江苏沛县221600

出　　处：《实用临床医药杂志》2009年第11期25-28,共4页Journal of Clinical Medicine in Practice

摘　　要：目的观察比较最佳支持治疗（BSC）、单药吉西他滨（GEM）或并卡铂（CBP）治疗老年晚期非小细胞肺癌的疗效、毒副反应以及患者的生存质量。方法拒绝化疗者人BSC组，接受化疗者随机分为GEM单药化疗组和GEM＋CBP联合化疗组。BSC组：最佳支持治疗。GEM组：GEM 1000mg／m^2静脉滴注30min，第1，8天。GEM4-CBP组：GEM1000mg／m^2静脉滴注30min，第1，8天；CBP AUB=4静脉滴注第1天。化疗组均21天为1周期，每例至少完成2周期化疗。结果近期疗效：总有效率BSC组O、GEM30．3％、GEM十CBP组46．7％，组间比较P〈0．05。毒副反应：主要表现为骨髓抑制和消化道反应，尽管Ⅲ～Ⅳ度毒副反应的发生率GEM＋CBP组明显高于GEM组（P〈0．05），但耐受性均较好。生存质量：临床受益率BSC组13．2％、BEM组48．5％、GEM＋CBP组50．0％，两化疗组优于BSC组（P〈0．05），但两化疗组之间相互比较无显著性差异（P〉0．05）。结论对于老年晚期NSCLC，化疗优于对症支持治疗，GEM＋CBP联合化疗的疗效优于GEM单药化疗，但联合化疗毒副反应相应增加，临床受益率未显示出优势。临床实践中，注意选择个体化方案治疗。Objective To observe the clinical efficacy, adverse effects and quality of life in patients trrated with best supportive care （BSC）, single gemcitabine（GEM） and gemcitabine plus carboplatin（CBP） for advanced non-small-cell lung cancer （NSCLC） in the aged. Methods Patients who refused chemotherapy joined the BSC group, and patients receiving chemotherapy were randomly divided into single-agent GEM group and gemcitabine plus earboplatin （GME ＋ CBP） group. Those in single-agent group were given GEM 1 000 rng/m^2 on the first day and eighth day, and those in combined group received GEM 1 000 mg/m^2 on the first day and eighth day and CBP AUB = 4 on the first day. All the drugs were given intravenously for 30 minutes. A cycle is 21 days and each case completed at least two cycles of treatment. Results In short-term effect, the response rate of BSC group was 0, GEM group was 30.3 % and GEM ＋ CBP group was 46.7 %. The difference was significant （P 〈 0.05）. The major toxic reaction was bone marrow depression and digestive tract reaction. Although Ⅲ ＋ Ⅳ degree of adverse effects rate of GEM ＋ CBP group was significantly higher than that the GEM group（P 〈 0.05）, the two groups were well tolerant. The clinical benefit rate of BSC group was 13.2 %, GEM group was 48.5 % and GEM ＋ CBP group was 50.0%. Two chemotherapy group was superior to BSC Group（P〈0.05）, but the difference was insignificant between the two chemotherapy groups （ P 〉 0.0 5 ） . Conclusion Chemotherapy is superior to symptomatic supportive care for advanced non-small-cell lung cancer （NSCLC） in the aged. Gemcitabine plus carboplatin is superior to single gemcitahine, but increases adverse effects and clinical benefit response rate is insignificant, clinical practice, should pay attention to individual treatment.

关 键 词：非小细胞肺癌 老年 化疗 吉西他滨 卡铂 

分 类 号：R734.2[医药卫生—肿瘤]