老年晚期非小细胞肺癌一线含铂两药化疗方案的疗效与安全性分析  

Analysis of efficacy and safety of platinum-based doublet chemotherapy as first-Line therapy for elderly patients with advanced non-small cell lung cancer

作　　者：刘雨桃[1] 孙宏妍[1] 张苗苗[1] 郭继红[1] 王子平[1] 李峻岭[1] 王宏羽[1] 王燕[1] 郝学志[1] 胡兴胜[1] 张湘茹[1] 石远凯[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院内科,北京100021

出　　处：《中国肿瘤临床与康复》2012年第2期173-177,共5页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：卫生部医药卫生科技发展基金(200902002-1);中央保健专项基金(B2009B124);吴阶平医学基金会临床科研专项资助基金(320.6799.1109)

摘　　要：目的评价老年晚期非小细胞肺癌一线含铂两药化疗方案的疗效和安全性。方法对2007年1月至2009年12月在中国医学科学院肿瘤医院一线接受含铂两药方案化疗的73例老年晚期非小细胞肺癌(NSCLC)患者的临床治疗情况进行回顾性分析。结果 73例老年晚期NSCLC患者,化疗方案含紫杉醇、吉西他滨、长春瑞滨和培美曲塞的患者分别为47例、21例、3例和2例;含顺铂或卡铂者分别为27例和46例。疗效评价完全缓解(CR)0例,部分缓解(PR)31例(42.5%),稳定(SD)28例(38.4%),进展(PD)14例(19.2%),疾病控制率为80.9%。化疗方案中,含顺铂或卡铂以及含紫杉醇或吉西他滨对客观有效率和疾病控制率的影响差异无统计学意义(P>0.05)。13例(17.8%)患者未出现明显的不良反应,32例(43.8%)出现1/2级的血液学或非血液学毒性,24例(32.9%)出现3/4级血液学毒性,4例(5.5%)出现3/4级非血液学毒性。在评价为PR或SD的59例患者中,中位化疗周期数为4个周期,有43例(72.9%)患者完成了≥4个周期的含铂两药方案化疗。中位无进展生存时间为6.8个月。结论三代化疗药物的含铂两药化疗方案对一般状态好的老年晚期非小细胞肺癌患者有较好的疗效和耐受性,可以作为其一线化疗的治疗选择。Objective The aim of this study is to evaluate the efficacy and safety of platinum-based doublet chemotherapy as first-Line therapy for elderly patients with advanced NSCLC.Methods The clinical data of 73 elderly advanced NSCLC patients referred to the Cancer Hospital Institute,Chinese Academy of Medical Sciences from Jan,2007 through Dec,2009 were analyzed retrospectively.Results 73 elderly patients with advanced NSCLC were assessed in this study.There were 47,21,3 and 2 patients received the chemotherapy regimen included paclitaxel,gemcitabine,vinorelbine and pemetrexed as first-line treatment,respectively.Complete remission,partial remission,stable disease,and progress disease were noted in 0,31（42.5%）,28（38.4%）,and 14（19.1%） of the patients,respectively,with the disease control rate being 80.9%.There were no significantly statistical differences in objective response rate and disease control rate between two groups whose regimen included cisplatin or carboplatin as well as paclitaxel or gemcitabine（P 0.05）.There were no adverse events developed in 13 patients（17.8%）,whereas 1/2 grade adverse events developed in 32 patients（43.8%）.3 /4 grade hematology toxicity or non-hematology toxicity occurred in 24（32.9%） and 4（5.5%） patients,respectively.The 59 patients assessed as partial remission or stable disease received median four chemotherapy cycles,and 43（72.9%） patients received more than four cycles platinum-based doublet chemotherapy.The median duration of progression-free survival was 6.8 months.Conclusion Platinum-based double-agent chemotherapy with a third-generation drug could be the first-line option for the elderly patients who had good performance status with advanced NSCLC for its therapeutic effect and tolerance.

关 键 词：肺肿瘤 药物疗法 铂类药物 老年人 

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