老年人晚期非小细胞肺癌化疗疗效及预后分析

目的探讨年龄≥65岁的晚期非小细胞肺癌（NSCLC）患者含铂方案化疗疗效及预后因素。方法回顾性分析70例年龄≥65岁的ⅢA～Ⅳ期NSCLC患者一线含铂方案化疗疗效及不良反应；Kaplan—Meier法分析生存情况，COX回归法进行多因素预后分析。结果全组中位化疗数为3个周期，共有53例患者可评价疗效，总有效率41．5％（22／53），且疗效不受年龄影响（X^2=1．945，P=0．378）；中位无进展生存时间6．0个月，中位生存时间12．5个月；化疗相关血液毒性发生率高；多因素分析提示ECOG评分、远处器官转移数目、化疗周期数是影响预后的独立因素。结论老年晚期NSCLC患者一线含铂方案化疗具有较高疗效，但不良反应发生率高，化疗耐受性较差，合理选择患者是关键；ECOG评分差、多发远处器官转移患者难以从化疗中获益；而对于可耐受化疗患者，3—6周期化疗可明显改善预后。

Chemotherapy effect and prognosis analysis of elderly patients with advanced non-small-cell lung cancer

Objective To evaluate the curative effect and toxicities of platinum-based double regimens for patients aged ≥ 65 with advanced non-small-cell lung cancer (NSCLC) and identify the prognosis factors. Methods 70 patients aged ≥65 with staged ⅢA-Ⅳ NSCLC, who received platinum-based double regimens as first line treatment, were emrolled.Response rates and toxicities were evaluated.Progression free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox regression analysis was used to identify the potential prognosis factors.Results The median chemotherapy cycles was 3.The overall response rate was 41.5 % (22/53), and there was no difference between patients aged ＜70 and ≥70 (χ2 =1.945, P =0.378).The median PFS and OS were 6.0 months and 12.5 months.The chemotherapyrelated hematologic toxicities were common.Multivariate analysis revealed that performance status, numbers of metastasis, chemotherapy cycles were significant independent predictive factors for OS. Conclusion In elderly advanced NSCLC, platinum-based doublets show inspiring efficacy, but with more adverse events, and could not be all well tolerated. It should be personalized. Patients with poor performance status and multiple organs metastasis are hard to benefit from combined chemotherapy.Three to six cycles of chemotherapy is the optimal duration for patients who could be well tolerated.