沙利度胺联合紫杉醇+顺铂方案治疗老年晚期非小细胞肺癌的疗效观察

目的探讨沙利度胺联合紫杉醇+顺铂(TP)方案治疗老年晚期非小细胞肺癌(NSCLC)患者的疗效及不良反应。方法选择老年(≥60岁)晚期NSCLC患者62例,所有病例均为初治患者,随机分为2组,治疗组31例,给予TP方案化疗,并于化疗第1天起口服沙利度胺100 mg/d,如患者能够耐受,1周后加量至200 mg/d,21 d为1个周期,连续口服3个月;对照组31例,给予,TP方案化疗。入组的每例患者至少接受2个周期的治疗。结果治疗组有效率为43.3%,对照组为38.7%(P>0.05);疾病控制率分别为86.7%和64.5%,差异有统计学意义(P<0.05);治疗组KPS评分好转率、食欲增加率及体质量增加率均优于对照组(P<0.05)。中位无进展生存时间(PFS)治疗组为7.97个月,对照组为5.94个月;中位总生存期(OS)治疗组为12.71个月,对照组为11.23个月,治疗组均较对照组延长(P<0.05)。不良反应主要为Ⅰ^Ⅱ级脱发、白细胞减少、肌肉关节痛及恶心呕吐,ⅢⅡ级脱发、白细胞减少、肌肉关节痛及恶心呕吐,Ⅲ^Ⅳ级发生率均较低,2组除恶心呕吐有显著差异(P<0.05)外,其余均无统计学意义(P>0.05)。未见沙利度胺相关的出血、血栓及ⅢⅣ级发生率均较低,2组除恶心呕吐有显著差异(P<0.05)外,其余均无统计学意义(P>0.05)。未见沙利度胺相关的出血、血栓及Ⅲ^Ⅳ级嗜睡、便秘等不良反应发生。结论沙利度胺联合TP方案治疗老年晚期NSCLC,提高了患者的疾病控制率、生活质量,延长了生存期,无明显不良反应,安全性高,值得临床推广应用。

Clinical observation on therapeutic effect of thalidomide in combination with paclitaxel plus cisplatin regimen in the treatment of elderly patients with advanced non-small cell lung cancer

Objective To investigate the efficacy and adverse reactions of thalidomide and paclitaxel and cisplatin（TP）in the treatment of elderly patients with advanced non-small cell lung cancer（NSCLC）.Methods Select the elderly（≥60 years）62 patients with advanced NSCLC,all cases were previously untreated patients were randomly divided into two groups,the treatment group of 31 patients received TP regimen,starting on the first day of chemotherapy oral thalidomide 100mg/d,if the patient can tolerate,one week after the dosage to 200mg/d,21 d as a cycle,continuous oral three months;control group of 31 patients received TP regimen.Each patient received at least two cycles of treatment.Results Effective rate in treatment group was 43.3%,in the control group was 38.7%（P0.05）;disease control rate was 86.7%and 64.5%,the difference was statistically significant（P0.05）;treatment group improved KPS score rate,the rate of increase in appetite and weight gain rate than the control group（P0.05）.The median progression-free survival（PFS）treatment group was7.97 months in the control group was 5.94 months;median overall survival（OS）treatment group 12.71 months in the control group 11.23 months,the treatment group than the control group extended（P0.05）.Adverse reactions were Ⅰand Ⅱ Class alopecia,leukopenia,muscle and joint pain,and nausea and vomiting,Ⅲ-Ⅳ grade low incidence,two groups in addition to nausea and vomiting were significantly different（P0.05）,the rest had no statistically significant（P0.05）.No thalidomide-related hemorrhage,thrombosis and Ⅲ-Ⅳ grade drowsiness,constipation and other adverse reactions.Conclusion The TP regimen of thalidomide treatment of advanced NSCLC,improve the patient＇s disease control rate,quality of life and prolong survival,no significant adverse reactions,safe,worthy of clinical application.