吉西他滨单药治疗老年晚期非小细胞肺癌的临床观察

目的观察了解吉西他滨单药治疗老年晚期非小细胞肺癌(NSCLC)的临床疗效和毒性反应。方法32例Ⅲ~Ⅳ期NSCLC患者均经病理组织学和(或)细胞学检查确诊。治疗剂量国产吉西他滨(泽菲)1000~1250mg/m2,静滴,第1、8天,每3~4周重复,2周期后CT评价疗效。结果32例患者均可评价,获得CR2例,PR6例,有效率25.0%(8/32)。中位疾病进展时间(TTP)为5.7个月,中位生存期6.7个月,1年生存率28.1%。最主要的毒副反应为白细胞及血小板降低,但均可耐受。结论吉西他滨单药治疗老年晚期NSCLC有较好疗效,可明显改善患者生存质量,延长生存时间,毒副反应轻,易于耐受。     

低剂量吉西他滨单药治疗老年非小细胞肺癌的临床观察

目的:观察低剂量吉西他滨单药治疗老年晚期非小细胞肺癌的疗效及毒副反应。方法:30例老年非小细胞肺癌患者采用吉西他滨600mg/m2,静脉滴注30分钟,第1、8、15天,28天为1周期,完成2周期以上评价疗效。结果:30例可评价疗效及毒性反应,全组无CR病例,PR9例,NC11例,PD10例,有效率30.0%(9/30),临床受益率66.7%。主要毒副反应为白细胞及血小板减少,均可耐受。结论:低剂量吉西他滨单药治疗老年非小细胞肺癌安全有效,值得临床推广使用。     

吉西他滨联合热疗治疗老年晚期非小细胞肺癌的临床研究

目的:探讨局部热疗联合单药吉西他滨(GEM)方案化疗治疗老年非小细胞肺癌(NSCLC)的临床疗效。方法:将65例老年NSCLC患者分成两组,观察组(n=34)采用GEM联合局部热疗,对照组(n=31)采用GEM单药化疗,21天为1周期,完成2个周期评价疗效、生活质量及不良反应。结果:观察组总有效率为47.06%,对照组为22.58%,两组差异有统计学意义(P<0.05);两组患者治疗前后KPS评分变化的差异有统计学意义(P<0.05);两组不良反应的发生率差异无统计学意义(P>0.05)。结论:GEM单药方案联合局部热疗可提高老年NSCLC的疗效。     

吉西他滨单药治疗老年晚期非小细胞肺癌患者36例

目的 观察吉西他滨单药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 对36例ⅢB～Ⅳ期老年NSCLC患者应用吉西他滨单药化疗(1000mg/m2,第1、8天静脉滴注),21 d为1个周期.2个周期后分别按实体瘤疗效评价标准(RECIST)和美国国立癌症研究所(NCI)常见毒性反应标准评价不良反应,同时评估生活质量改善指标.结果 本组36例患者中,完全缓解(CR)0例,部分缓解(PR)10例,稳定(SD)15例,进展(PD)11例,有效(CR+PR)率为27.8%,临床受益(CR+PR+SD)率为69.4%.中位无进展生存(PFS)期为5.1个月,中位总生存(OS)期为7.8个月,1年生存率为30.6%(11/36).患者不良反应主要表现为以白细胞和血小板减少为主的骨髓抑制,白细胞减少Ⅰ～Ⅱ度发生率为44.4%(16/36),Ⅲ～Ⅳ度11.1%(4/36);血小板减少Ⅰ～Ⅱ度发生率为38.9%(14/36),Ⅲ度2.8%(1/36),无Ⅳ度减少发生.结论 采用吉西他滨单药治疗老年晚期NSCLC患者疗效好、不良反应轻、安全,可作为老年晚期NSCLC患者的一线治疗方案.     

吉西他滨单药治疗老年晚期非小细胞肺癌患者36例

目的 观察吉西他滨单药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 对36例ⅢB～Ⅳ期老年NSCLC患者应用吉西他滨单药化疗(1000mg/m2,第1、8天静脉滴注),21 d为1个周期.2个周期后分别按实体瘤疗效评价标准(RECIST)和美国国立癌症研究所(NCI)常见毒性反应标准评价不良反应,同时评估生活质量改善指标.结果 本组36例患者中,完全缓解(CR)0例,部分缓解(PR)10例,稳定(SD)15例,进展(PD)11例,有效(CR+PR)率为27.8%,临床受益(CR+PR+SD)率为69.4%.中位无进展生存(PFS)期为5.1个月,中位总生存(OS)期为7.8个月,1年生存率为30.6%(11/36).患者不良反应主要表现为以白细胞和血小板减少为主的骨髓抑制,白细胞减少Ⅰ～Ⅱ度发生率为44.4%(16/36),Ⅲ～Ⅳ度11.1%(4/36);血小板减少Ⅰ～Ⅱ度发生率为38.9%(14/36),Ⅲ度2.8%(1/36),无Ⅳ度减少发生.结论 采用吉西他滨单药治疗老年晚期NSCLC患者疗效好、不良反应轻、安全,可作为老年晚期NSCLC患者的一线治疗方案.     

吉西他滨加奥沙利铂治疗老年晚期非小细胞肺癌的临床观察

目的:评价吉西他滨联合奥沙利铂治疗晚期非小细胞肺癌(NSCLC)的临床疗效和毒副作用。方法:2005年1月~2008年1月住院的NSCLC患者48例,其中鳞癌23例、腺癌16例、腺鳞癌4例、支气管肺泡癌2例、大细胞癌3例,临床分期Ⅲ期30例、Ⅳ期18例。所有患者接受吉西他滨+奥沙利铂治疗,吉西他滨1000 mg/m2,第1天和第8天,奥沙利铂130 mg/m2,第1天。21天为1周期,共进行2个周期。结果:总有效率为45.8%,临床分期Ⅲ期有效率50.0%,Ⅳ期38.89%,组间无区别。治疗后的主要毒副反应为血液学毒性。白细胞减少、贫血及血小板减少,其Ⅲ度和Ⅳ度发生率分别为29.17%、18.75%和31.25%。生存质量有明显改善。结论:采用吉西他滨联合奥沙利铂治疗NSCLC患者有较好疗效,毒副作用可以耐受,是老年晚期NSCLC患者较为合适的一线治疗方案。     

吉西他滨单药治疗老年晚期非小细胞肺癌46例

[目的]观察吉西他滨单药治疗老年晚期非小细胞肺癌（NSCLC）的临床疗效和毒性反应。[方法]46例Ⅲ～Ⅳ期NSCLC患者均经病理组织学或细胞学检查确诊。国产吉西他滨（泽菲）1000mg/m2,静滴,d1、8,每3～4周重复,2个周期后CT评价疗效。[结果]46例患者均可评价疗效,无CR,PR12例,有效率26.0%,中位生存期7.1个月,中位疾病进展时间（TTP）6.2个月,1年生存率32.5%。主要的毒副反应为白细胞及血小板降低,均可耐受。[结论]吉西他滨单药治疗老年晚期NSCLC疗效确切,可明显改善患者生存质量,延长生存时间,毒副反应轻。     

国产吉西他滨联合长春瑞滨治疗紫杉醇耐药的晚期老年非小细胞肺癌的临床观察

目的:研究国产吉西他滨联合长春瑞滨(GN方案)治疗紫杉醇耐药的老年进展期非小细胞肺癌(NSCLC)的临床应用价值。方法:32例Ⅲ期和Ⅳ期NSCLC老年患者经过紫杉醇联合顺铂治疗3周期以上无效,改为接受GN方案治疗,吉西他滨1250mg/m2,静脉滴入,d1、d8;长春瑞滨25mg/m2,静脉滴入,d1、d8,21～28d为1周期。所有病例均接受3周期以上治疗,按照WHO标准评价疗效和毒性。结果:32例紫杉醇耐药的Ⅲ期和Ⅳ期老年患者经本方案化疗3～6个周期后,有效率分别为38.9%和21.4%,总有效率为31.2%;中位生存期为9个月,1年生存率为44.4%和14.3%,总的1年生存率为31.3%。毒副反应主要为Ⅱ～Ⅳ度的骨髓抑制和Ⅰ～Ⅱ度的消化道反应。结论:国产吉西他滨联合长春瑞滨(GN方案)对紫杉醇耐药的进展期NSCLC老年患者有效,患者耐受性好,并能延长患者生存期,改善生活质量。     

吉西他滨单药治疗老年晚期非小细胞肺癌的临床观察

目的 观察吉西他滨单药治疗老年晚期非小细胞肺癌(NSCLC)的疗效及毒副反应.方法 观察组36例老年晚期NSCLC,年龄≥65岁,应用吉西他滨1000 mg/m2,静脉滴注,d1,8,每21d为1周期,至少2个周期.对照组26例老年晚期NSCLC给予最佳支持治疗(BSC).结果 吉西他滨治疗组有效率(RR)为27.78%,中位疾病进展时间5.4个月,中位生存期8.6个月,1年生存率36.11%;对照组有效率(RR)为0,中位疾病进展时间2.7个月,中位生存期4.6个月,1年生存率11.53%.观察组毒副反应较轻,无因毒副反应停药者.结论 吉西他滨单药治疗老年晚期NSCLC安全有效,可延长患者的生存时间,改善其生活质量;毒副反应可以耐受.     

单药吉西他滨治疗老年晚期非小细胞肺癌疗效观察

目的观察单药吉西他滨治疗老年晚期非小细胞肺癌的疗效和不良反应。方法收集Ⅲ～Ⅳ期老年非小细胞肺癌患者54例,根据是否应用吉西他滨分为试验组和对照组,试验组30例患者应用单药吉西他滨800～1 000 mg/m2,第1、8天静脉滴注,21天为1周期,至少2周期;对照组给予最佳支持治疗。结果30例患者均可评价疗效,其中,完全缓解0例,部分缓解9例,有效率为30.0%(9/30)。中位疾病进展时间（TTP）为4.9月,中位生存期为6.5月。主要不良反应多为Ⅰ～Ⅱ度骨髓抑制及皮疹。结论单药吉西他滨治疗老年晚期非小细胞肺癌是安全有效的。     

多西他赛周疗法治疗老年晚期非小细胞肺癌的临床观察

目的：观察多西他赛单药每周方案治疗老年晚期非小细胞肺癌（NSCLC）的临床疗效及毒副反应。方法：国产多西他赛35mg／m^2静脉滴注1小时，第1、8、15天，28天为1个周期，治疗65岁以上NSCLC患者并评价疗效及毒副反应。结果：28例患者共化疗86个周期，总有效率（CR＋PR）为35．7％（10／28），临床受益率（CR＋PR＋NC）为64．3％（18／28）。经治疗后患者KPS平均分从基线时的75．5上升至87．7（P〈0．01），咳嗽、咯血、胸痛和气促LCSS平均分从治疗前的64、65、62和65分上升至90、92、87和88分（P〈0．01）。肿瘤中位疾病进展时间为5．3个月，中位生存期为8．5个月。主要毒副作用为疲劳和骨髓抑制，但均可耐受。 结论：多西他赛周疗法治疗老年NSCLC有较好的疗效，并能有效改善症状，且患者耐受性较好。     

三维适形放疗联合周剂量奈达铂治疗老年非小细胞肺癌的临床观察

目的：探讨三维适形放疗联合周剂量奈达铂治疗老年非小细胞肺癌（ NSCLC）的疗效及毒副反应。方法选择63例老年NSCLC患者,随机分为2组,其中观察组31例,对照组32例,均予三维适形放疗,观察组同步进行周剂量奈达铂化疗。结果观察组、对照组疾病控制率分别为80.6%和68.6%;1 a生存率分别为77.4%和68.8%。2组主要毒副反应为急性放射性肺炎、支气管炎,急性放射性食管炎,骨髓抑制等。结论三维适形放疗联合周剂量奈达铂治疗老年NSCLC疗效较好,毒副反应可耐受。     

Combination of low-dose cisplatin and gemcitabine for treatment of elderly patients with advanced non-small-cell lung cancer

PURPOSE: To evaluate the feasibility, toxicity and efficacy of the combination of low-dose cisplatin (CDDP) and gemcitabine (GEM) in elderly patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: This phase II trial included 46 patients aged 70 years or older with previously untreated advanced NSCLC. All patients were evaluable for response and toxicity. Treatment consisted of CDDP 50 mg/m(2) on day 1 plus GEM 1000 mg/m(2) on days 1 and 8. The regimen was repeated every 21 days. Patients received a minimum of three courses unless progressive disease was detected. RESULTS: A total of 190 GEM-CDDP courses were administered (median 4.1 courses per patient). The chemotherapy regimen was well tolerated. No patients developed grade 4 toxicity. Grade 3 toxicities were as follows: neutropenia in six patients (13%), and anemia, thrombopenia and nausea/vomiting in one (2%) each. Two patients (4%) had mild nephrotoxicity. Of the 46 patients, 16 had a partial response (35%, 95% confidence interval, CI, 28-52%), 17 (37%) remained stable and 13 (28%) had disease progression. Eastern Cooperative Oncology Group performance status improved in 17 patients (37%), whereas 25 (54%, 95% CI 44-74%) showed a clinical benefit. Median time to progression was 20 weeks. Overall median survival was 44 weeks, with a 1-year actuarial survival rate of 35%. CONCLUSIONS: The combination of low-dose CDDP and GEM for elderly patients with advanced NSCLC is an effective and well-tolerated chemotherapeutic approach.     

胸腺肽α_1联合低剂量吉西他滨治疗老年晚期非小细胞肺癌临床研究

目的观察及评价胸腺肽α1联合低剂量吉西他滨（泽菲）对老年晚期非小细胞肺癌的临床疗效。方法 58例老年晚期非小细胞肺癌患者,随机分为对照组（化疗）和治疗组（化疗＋胸腺肽α1）,治疗组30例,对照组28例。治疗组在化疗的同时给予1.6 mg胸腺肽α1皮下注射,隔日1次,连续应用8周,对照组则在化疗的同时给予等剂量生理盐水,用法与治疗组相同。所有患者均采用低剂量泽菲化疗（800 mg/m^2,d1,d8）并记录患者Kanofsky体力评分及体重变化。结果治疗后治疗组患者的Kanofsky评分明显高于对照组（P〈0.05）。体重增加明显高于对照组,差异有统计学意义（P〈0.05）。治疗组不良反应明显低于对照组,差异无统计学意义（P〉0.05）。结论胸腺肽α1可改善老年晚期非小细胞肺癌患者生活质量,未增加化疗的不良反应。     

Elderly patients with advanced non-small cell lung cancer. A pase II study with weekly cisplatin and gemcitabine

OBJECTIVES: The incidence of non-small cell lung cancer (NSCLC) is increasing among the elderly. We studied the toxicity and efficacy of a weekly schedule of gemcitabine and cisplatin in elderly patients with advanced NSCLC. METHODS: Patients aged 70 years or above with advanced NSCLC were treated in a phase II prospective trial with gemcitabine 1,000 mg/m(2) and cisplatin 35 mg/m(2) on days 1, 8 and 15 every 28 days. RESULTS: Forty-eight patients with a median age of 74 years (range 70-78) participated in the study. We observed 14 cases with partial response, 14 with stable disease and 16 with progressive disease, whilst 4 patients were not evaluable. By intention-to-treat analysis, partial response rate was 31.8% whilst progressive disease was 33.3%. Median survival was 9 months; 1-year survival probability was 34.4% and median time to progression was 4 months. Grade III-IV leukopenia was observed in 5/48 patients (10.4%), 20/48 patients (41.7%) had grade III-IV thrombocytopenia and 7/48 patients (14.6%) had grade III-IV anemia. One patient experienced grade III emesis and 2 patients had grade III-IV fatigue. CONCLUSIONS: At this dose and schedule the combination of gemcitabine and cisplatin appears to be an active and well-tolerated regimen for elderly patients with advanced NSCLC.     

多西他赛单药治疗老年晚期非小细胞肺癌的临床观察

目的：观察多西他赛单药治疗晚期非小细胞肺癌（ＮＳＣＬＣ）老年患者的临床疗效和不良反应。方法：４２例晚期ＮＳＣＬＣ初治老年患者予以多西他赛７０ｍｇ／ｍ^２治疗,２１天为１周期,治疗２～４周期,随访至疾病进展和死亡。结果：ＣＲ１例,ＰＲ９例,ＳＤ１３例,ＰＤ１７例,总有效率（ＣＲ＋ＰＲ）３５.０％,疾病控制率（ＣＲ＋ＰＲ＋ＳＤ）５７.５％,中位无进展生存期４.２个月,中位生存期６.１个月,１年生存率为３５.８％。主要毒副反应为骨髓抑制和血小板减少。结论：多西他赛单药治疗老年晚期ＮＳＣＬＣ有效且耐受性好。     

多西他赛周疗法治疗老年晚期非小细胞肺癌临床效果

Objective: To investigate the clinical efficacy and toxicity of weekly dose docetaxel monotherapy schedule in elderly with advanced non-small cell lung cancer (NSCLC). Methods: 28 patients aged over 65 with advanced NSCLC were recived with docetaxel (Aisu) 35 mg/m2 on days 1, 8 and 15 every 28 days. A clinical evaluation on effectiveness, quality of life and toxicities was performed. Results: 28 patients were given 86 cycles' chemotherapy altogether. The overall response rate was 35.7% (10/28). The clinical beneficial rate was 64.3% (18/28). Mean KPS was increased from 75.5 at baseline to 87.7 after chemotherapy (P < 0.01); lung cancer symptom scale (LCSS) scores of cough, hemoptysis, chest pain and dyspnea were increased from 64, 65, 62 and 65 to 90, 92, 87 and 88, respectively (P < 0.01). The median time to progression (TTP) was 5.3 months; median survival time (MST) was 8.5 months. The main toxicities were fatigue, leukopenia and decrease of hemoglobin with well tolerance. Conclusion: Weekly dose docetaxel monotherapy schedule is a feasible, well-tolerated, and active scheme in the treatment of the elderly patients with advanced NSCLC.     

紫杉醇脂质体单药一线治疗老年晚期非小细胞肺癌的临床观察

目的 观察紫杉醇脂质体单药一线治疗老年晚期非小细胞肺癌（NSCLC）的近期疗效及不良反应。方法 21例经病理或细胞学确诊初治老年非小细胞肺癌患者,年龄≥65岁,KPS评分≥70分,其中19例合并程度不等的各种疾病。采用紫杉醇脂质体175mg/m2,静脉给药,每3周给药1次。2周期后评价疗效,观察近期疗效和化疗期间不良反应。结果 完全缓解(CR)0例,部分缓解（PR）5例(23.8%),稳定（SD）10例(47.6%),进展（PD）6例（28.6%）,有效率RR 23.8%,疾病控制率DCR为71.4%。主要不良反应为血液学毒性、胃肠道反应、肝功能损害,但均以Ⅰ、Ⅱ级为主。发生Ⅲ～Ⅳ级粒细胞减少为3例（14.2％）,无感染与发热。无因化疗不良反应导致延迟或终止治疗,无化疗相关性死亡。结论 一般状况较好的老年晚期NSCLC患者采用紫杉醇脂质体单药化疗安全、有效,不良反应低,患者耐受性好。     

Japanese experience with second-line chemotherapy with low-dose (60 mg/m2) docetaxel in patients with advanced non-small-cell lung cancer

PURPOSE: To assess the efficacy and toxicity of relatively low-dose docetaxel (60 mg/m2) for previously treated advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with advanced (clinical stage IIIA-IV) NSCLC who had previously undergone at least one series of chemotherapy were enrolled. Previous paclitaxel use was allowed, but docetaxel was not. Docetaxel was administered at an initial dose of 60 mg/m2 intravenously on day 1 over 90 min every 3 weeks. RESULTS: From June 1997 to November 1999, 22 patients were entered into this study. The total number of cycles delivered to 22 patients was 53, with a median per patient of 2. Four patients achieved a partial response (PR), and the overall response rate was 18.2% (95% confidence interval 5.1-40.3%). The median time to progression was 13.7 weeks. The median survival time was 7.8 months, and the 1-year survival rate was 25%. About 73% of patients experienced grade 3 or 4 neutropenia. Neutropenic fever was observed in four patients (18%). Non-hematologic toxicities were generally mild. No treatment-related deaths occurred. CONCLUSIONS: Although the validity of the results of this study is limited due to the small and monoracial study population examined, low-dose (60 mg/m2) docetaxel for previously treated advanced NSCLC appears to yield antitumor activity and survival benefit comparable to those obtained with the conventional dose (100 mg/m2).     

Measurement and impact of co-morbidity in elderly patients with advanced non-small cell lung cancer treated with chemotherapy. A phase II study of weekly paclitaxel

BACKGROUND: Aging is associated with an increasing of comorbidity and at the time of lung cancer diagnosis patients present one or more other serious disease. The aim of the study is to evaluate tolerability, response and survival of weekly paclitaxel in elderly patients with advanced NSCLC and concomitant diseases. METHODS: Patients with advanced NSCLC who were poor candidates to platinum-based therapy because of age >65 years and coexistent illnesses received weekly paclitaxel over 1 hour at a dose of 80 mg/m2. Comorbidity was evaluated according to the Charlson scale, Kaplan-Feinstein index and the Cumulative Illness Rating Scale. RESULTS: A total of 57 patients (median age, 74 years; range, 65-84) were included. The overall response rate was 44%. Median survival was 7.8 months. Grade 3-4 toxicity was uncommon: neutropenia 1.8%, thrombocytopenia 1.8%, neuropathy 7%, hypersensitivity reaction 1.8%. Comorbidity indexes were useful to characterize better the population of elderly patients, but did not define a subgroup with worse prognosis. CONCLUSIONS: The low toxicity profile and efficacy of low-dose weekly paclitaxel justified its usage in this group of poor prognosis elderly patients with advanced NSCLC and comorbidities. A comorbidity index should be introduced in prospective oncological studies in the elderly to ensure compatibility.