吉西他滨联合替吉奥二线治疗老年ⅢB期肺鳞癌的疗效观察  

Clinical observation of gemcitabine plus S-1 as a second-line therapy in aged patients with stage ⅢB squamous cell lung cancer

作　　者：张杰[1] 徐可[1] 王少龙[1] 

机构地区：[1]成都医学院第一附属医院肿瘤科,成都610500

出　　处：《临床肿瘤学杂志》2016年第6期530-534,共5页Chinese Clinical Oncology

基　　金：成都医学院"鸵鸟计划"专项基金资助项目(CYX12-025)

摘　　要：目的探讨吉西他滨联合替吉奥方案二线治疗老年肺鳞癌ⅢB期患者的疗效。方法将本院2009年11月至2014年9月符合条件的肺鳞癌患者共105例随机分为吉西他滨联合替吉奥(GS)组及吉西他滨单药(GEM)组。2个周期后按照RECIST 1.1版标准评价近期疗效,采用国立癌症研究所毒性判定标准(NCI CTC)4.0评价化疗毒性反应,同时随访其生存情况并采用Cox风险比例回归模型分析影响预后的因素。结果全组105例患者均可评价疗效和毒副反应,其中GS组的有效率和疾病控制率分别为39.62%(21/53)和49.06%(26/53),均高于GEM组的19.23%(10/52)和26.92%(14/52),差异有统计学意义(P<0.05);GS组的中位无进展生存期和总生存期分别为4.3个月和9.2个月,优于GEM组的3.8个月和8.0个月,差异均有统计学意义(P<0.05);与GEM组相比,GS组的白细胞降低、恶心呕吐、腹泻、便秘、腹痛、口腔溃疡、皮疹及疲乏的发生率较高,差异均有统计学意义(P<0.05);多因素分析后TNM分期及进展时间是影响总生存期的独立因素。结论对老年、肺鳞癌患者的二线治疗,采用GS方案较单药GEM方案在提高近期疗效及预后上有优势,但不良反应较重,可以有选择地用于身体状况较好的患者。Objective To explore the effect of gemcitabine（ GEM） plus S-1（ GS） regime as a second-line therapy in aged patients with stage ⅢB nonoperative squamous cell lung cancer. Methods The clinical data of these eligible patients was collected from November 2009 to September 2014. A total of 105 patients were randomized divided into GS group and GEM group. Response to chemotherapy was assessed by RECIST criteria 1. 1 and toxicity was evaluated according to National Cancer Institute Common Toxicity Criteria 4. 0. The clinical follow-up data from chemotherapy were investigated. The factors influencing the prognosis of the patients with Cox risk proportional regression model. Results All 105 patients were evaluable for recent efficacy and safety. The response rate and the disease control rate were 39. 62%（ 21 / 53） and 49. 06%（ 26 / 53） in GS group,higher than 19. 23%（ 10 / 52） and 26. 92%（ 14 /52） of GEM group（ P〈0. 05）. The median progression-free survival and overall survival were 4. 3 months and 9. 2 months in the GS group,better than 3. 8 months and 8. 0 months in the GEM group（ P 0. 05）. Compared with GEM group,the incidences of white blood cell decrease,nausea and vomiting,diarrhea,constipation,abdominal pain,mouth ulcers,skin rash and fatigue were significantly higher in GS group than in GEM group（ P〈0. 05）. TNM stage and development time were the independent factors affecting the overall survival by multiple factor analysis. Conclusion The GS regimen is more benifitial than the GEM monotherapy regimen as the second-line therapy in treating elder patients with squamous cell lung cancer in improving the efficacy and prognosis. The adverse reactions were more serious in GS regimen,which should be used in specific patients with better physical health due to its potential serious adverse events.

关 键 词：吉西他滨 替吉奥 肺鳞癌 二线治疗 

分 类 号：R737.9[医药卫生—肿瘤]