健择联合卡铂治疗70岁以上进展期非小细胞肺癌患者的观察

目的观察健择联合卡铂方案治疗70岁以上老年进展期非小细胞肺癌(NSCLC)患者的疗效及副反应,评价该方案的可行性。方法对采用健择联合卡铂化疗的44例进展期NSCLC患者(初治)进行回顾性分析,其中70岁以下24例,70岁以上20例。化疗方案:<70岁健择1200mg/m2,d1,8;卡铂AUC=5,d1;≥70岁健择1000mg/m2,d1,8;卡铂AUC=4,d1。每3周重复,至少治疗2周期,2周后评价疗效。结果70岁以下组共完成89周期化疗,平均3.7周期,有效率(CR+PR)45.8%,70岁以上组共完成66周期,平均3.3周期,有效率(CR+PR)40.0%,两组近期有效率比较差异无统计学意义(P>0.05)。两组在Ⅲ~Ⅳ骨髓抑制、严重恶心呕吐、脱发、肝肾功能损害方面差异无统计学意义(P>0.05),70岁以下组严重便秘1例,70岁以上组5例,差异有统计学意义(P<0.05)。两组中分别有2例患者化疗后血小板明显升高,1例56岁男性患者发生双下肢深静脉血栓,抗凝治疗后好转。结论健择联合卡铂化疗治疗70岁以上进展期NSCLC,疗效较好,毒副反应可耐受。

Clinical Observation of Gemcitabine with Carboplatin in Elderly Patients with Advanced Non-small Cell Lung Cancer

Objective 　To evaluate the effect and toxicity of gemcitabine with carboplatin in elderly patient s with advanced non2small cell lung cancer (NSCLC) . Methods 　Forty2four patient s (24 patient s less than 70 years old and 20 patient s over 70 years old ) received chemotherapy with gemcitabine and carboplatin as follows : gemcitabine (1 200 mg/ m2 ) iv on day1 and 8 , and carboplatin iv on day1 , AUC = 5 in pa2 tient s less than 70 years old ; gemcitabine (1 000 mg/ m2 ) iv on day1 and 8 , and carboplatin iv on day1 , AUC = 4 in patient s over 70 years old. At least 2 cycles finished of each patient . Results 　Eighty2nine cy2 cles of chemotherapy were completed in patient s less than 70 years old , average cycle was 3. 7 , the re2 sponse rate (CR + PR) was 45. 8 %. Sixty2six cycles of chemotherapy were completed in patient s over 70 years old , average cycle was 3. 3 , the response rate (CR + PR) was 40. 0 % , the response rate was no sig2 nificant difference between two groups. The toxicities was no significant difference between two groups such as Ⅲ～ Ⅳ bone marrow suppression , severe nausea/ vomiting , alopecia , impaired liver toxicity and renal toxicity( P > 0. 05) . One patient had severe costive in group of less than 70 years old , and 5 patient s in group of over 70 years old , there was significant difference between two groups ( P < 0. 05) . Af ter chemotherapy , platelet risen significantly in 2 patient s of each group respectively , one patient of 56 years old caught deep venous thrombosis , and he released af ter accepted antithrombotic therapy. Conclusion 　 The combination of gemcitabine and carboplatin is a feasible , well2tolerated and effective scheme in the t reatment of NSCLC patient s over 70 years old.