高龄广泛期小细胞肺癌49例的临床观察  

Clinical observation of 49 elderly patients with small cell lung cancer patients at extensive stage

作　　者：孟弃逸[1] 郭丽丽[1] 李明智[1] 仝丽[1] 武伟[1] 刘喆[1] 唐俊舫[1] 

机构地区：[1]首都医科大学附属北京胸科医院北京肺癌诊疗中心,北京101149

出　　处：《临床肺科杂志》2016年第10期1778-1781,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究高龄广泛期小细胞肺癌患者的疗效和毒副反应。方法共入选49例,采用含铂两药化疗40例,依托泊苷80mg/m^2,第1~3天;卡铂200~250 mg/m^2,第1天,每3~4周为一个周期,连用2~4周期;非含铂方案化疗9例。结果 14.2%患者完成1周期(7/49),30.6%完成2周期化疗(15/49),能够完成3周期以上化疗患者占55.1%(27/49),平均化疗周期2.94个。化疗有效率53.1%(26/49),疾病控制率72.1%(35/49),无效28.6%(14/49)。ED期患者中8例接受了二线治疗。中位生存期8.6个月,95%可信区间(5.88~8.66)49例可评价毒副反应,WHO III度以上中性粒细胞减少发生率分别为48.9%(24/49)、粒细胞减少性发热32.4%(16/49),非血液学毒性前2位是乏力、恶心呕吐,减少发生率分别为78.9%、56.2%。结论高龄广泛期小细胞肺癌联合化疗有生存获益,化疗疗效PR及化疗3周期以上与生存密切相关,骨髓抑制是剂量限制性毒性,毒副反应可耐受。Objective To investigate the activity and toxicity of elderly patients with small cell lung cancer patients at extensive stage. Methods 49 patients were enrolled,and 40 cases received Etoposide 80 mg / m2.（ d1-3） and carboplatin 200-250 mg / m^2.（ d2）. All treatment was delivered every 3 or 4 weeks. 9 cases received non Etoposide and carboplatin chemotherapy. Results 7 patients completed one course（ 14. 2%）,15 case for 2 courses（ 30. 6%）,and 27 case for more than 2 courses（ 55. 1%）. The average chemotherapy duration was 2. 94 courses.The effective rate of chemotherapy was 53. 1%（ 26 /49）,the disease control rate was 72. 1%（ 35 /49）,and the ineffective rate was 28. 6%（ 14 /49）. 8 cases at ED stage received second-line treatment. The mdian survival time was8. 6 months. The incidence of neutrophilic granulocyte at WHO grade III was 48. 9%（ 24 /49）. The incidence of granulopenia fever was 32. 4%（ 16 /49）. The top 2 of non-blood toxicity were hypodynamia and nausea and vomitting（ 78. 9% and 56. 2%）. Conclusion The combination of etoposide and carboplatin is effective and tolerable in treatment of elderly patients with small cell lung cancer at extensive stage,which can prolong their survival term and its toxicity is tolerable.

关 键 词：依托泊苷 小细胞肺癌 铂类 联合化疗 高龄 

分 类 号：R734.2[医药卫生—肿瘤]