老年晚期非小细胞肺癌化疗进展  

Progress in Chemotherapy for Elderly Advanced Non - small Cell Lung Cancer

作　　者：迟德财（综述）[1] 姜维良（审校 

机构地区：[1]哈尔滨医科大学附属第二医院,哈尔滨150086

出　　处：《实用肿瘤学杂志》2012年第1期86-91,共6页Practical Oncology Journal

摘　　要：超过47%非小细胞肺癌（NSCLC）患者在诊断时年龄大于70岁,由于老年患者常常合并其他疾病,所以与年轻人相比对化疗耐受性差.尽管化疗在年轻群体中能够得到很多临床证据,但不能盲目的不经选择的应用于老年NSCLC中.目前有大量的关于老年非小细胞肺癌患者的化疗和靶向治疗的前瞻性研究数据.在老年非小细胞肺癌中,基于Ⅱ期和Ⅲ期临床试验,单药化疗主要为第三代化疗药物（长春瑞滨,吉西他滨,紫杉醇）,认为是所有患者的常规治疗方案,Ⅱ期临床试验同时也显示出以铂类为基础联合方案的可行性和有效性.同样在相关的Ⅱ期临床中也显示了靶向治疗表皮生长因子酪氨酸激酶抑制剂（厄洛替尼和吉非替尼）及抗血管生成药物（贝伐单抗）作为老年患者一线治疗的可行性.本文对老年晚期非小细胞肺癌化疗新进展进行综述.More than 47% of cases of all NSCLC are diagnosed in patients over the age of 70 years. Elderly patients have more comorbidities and tend to he less tolerant to toxic medical treatments than younger. Thus, clinical data obtained in a younger population cannot be automatically extrapolated to the great majority of nonseleered elderly patients with Non - small Cell Lung CanCer（NSCLC）. The bulk of prospective clinical data regarding chemotherapy and molecularly targeted therapy for elderly NSCLC patients come from studies in advanced disease. In elderly advanced NSCLC patients, single - agent chemotherapy with third - generation agents （ vinorel- bine, gemcitabine, taxanes）is to be considered the routine standard of care for unseleeted patients, based on phase ]I and III trials specifically designed for this special population. Cisplatin - based chemotherapy with cisplatin at has been demonstrated to be an active and feasible option in phase II trials. Among targeted therapies, the epidermal growth factor receptor tyrosine kinase inhibitors, erlotinib and gefitinib, antivascular endothelial growth factor monoelonal antibody,bevaeizumab, have relevant phase 11 prospective data showing activity and good tolerability as first -line treatment in this population. In this article ,we review progress on chemotherapy for elderly advanced NSCLC.

关 键 词：老年 非小细胞肺癌 化疗 

分 类 号：R734.2[医药卫生—肿瘤]