GC方案作为诱导方案治疗老年局部晚期非小细胞肺癌的临床观察

目的：评价吉西他滨联合卡铂在老年不可手术的局部晚期非小细胞肺癌（non-small cell lung canc-er,NSCLC）作为诱导方案的疗效和安全性。方法：对于有明确的病理或细胞学诊断,年龄在65-75岁的晚期不可手术的NSCLC患者78例,应用GEM联合CBP化疗,GEM1000mg/m2静脉滴入第1、8天,CBP AUC为4,在第1天给药。21d为1个周期,共2个周期。并按RECIST标准评价疗效和WHO不良反应分级标准记录不良反应。结果：可评价的78例患者,共完成156个周期化疗,CR 0例,PR 32例,NC 37例,PD 9例,总有效率为41.0%。主要不良反应为骨髓抑制和消化道反应。结论：GEM联合CBP作为老年不可手术的晚期NSCLC诱导治疗是安全有效的,不良反应可以接受。     

吉西他滨联合卡铂作为诱导方案治疗老年不可手术的非小细胞肺癌

背景与目的：肺癌目前为世界范围内的高发病，每年世界范围内新增病例超过50万例，在我国的大中城市，肺癌的发病率已是恶性肿瘤发病率的首位。其中局部晚期的不可切除的非小细胞肺癌（non—small cell lung cancer，NSCLC）约占40％，随着我国老年人口的增加，肺癌在老年人群中的发病率呈增长趋势，往往由于症状隐匿发病时已是晚期且不可手术治疗。本研究目的是为了评价吉西他滨（GEM）联合卡铂（CBP）在老年不可手术的局部晚期非小细胞肺癌（NSCLC）作为诱导方案的疗效和安全性。方法：对于有明确的病理或细胞学诊断，年龄在65—75岁的晚期不可手术的NSCLC患者，应用GEM联合CBP化疗，用药方法为：GEM1000mg／m^2静脉滴入第1、8天，CBPAUC为5，在第1天给药。21d为1个周期，共2—3个周期。并按RECIST标准评价疗效和WHO毒副反应分级标准记录毒副反应，评价治疗后疗效。结果：可评价的42例患者，共完成89个周期化疗，CR0例，PR17例，NC22例，PD3例，总有效率为40．5％。主要毒副作用为骨髓抑制。结论：GEM联合CBP作为老年不可手术的晚期NSCLC诱导治疗是安全有效的，毒性反应可以接受。     

GEMOX方案治疗晚期非小细胞肺癌的临床疗效观察

目的 观察吉西他滨(GEM)联合奥沙利铂(L-OHP)组成的GEMOX方案治疗晚期非小细胞肺癌(NSCLC)的近期临床疗效和毒副反应,并与吉西他滨联合顺铂(DDP)组成的GP方案相比较.方法 将收治的晚期NSCLC患者随机分成GEMOX组和GP组.GEMOX组24例:GEM 1 000 mg/m2加入NS 100 mL中静滴,d1,8,L-OHP 130 ms/m2加入5%GS 500 mL中静滴,d1;GP组25例:GEM 1 000 mg/m2加入NS 100 mL中静滴,d1,8,DDP 25 mg/m2加入NS 500 mL中静滴,d1,8;两方案均3周重复,每例至少完成2疗程后评价疗效.结果 GEMOX组和GP组的总有效率分别为45.8%和48.0%;两组的疾病进展时间(TTP)分别为33周和30周,差异均无统计学意义.毒副反应方面,GEMOX组的神经毒性明显高于GP组,GP组的恶心呕吐和肾毒性明显高于GEMOX组;生活质量方面,无论QOL评分或PS评分,GEMOX组明显好于GP组.结论 吉西他滨联合奥沙利铂治疗晚期非小细胞肺癌,疗效与GP方案相仿,毒副反应轻,治疗耐受性好,是较为理想的治疗晚期非小细胞肺癌的化疗方案.     

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.     

GP方案治疗晚期非小细胞肺癌疗效观察

目的观察GP方案治疗晚期非小细胞肺癌的疗效与毒性反应。方法60例符合条件的患者接受下述联合方案化疗2周期,吉西他滨1250mg/m2iv d1、8,顺铂25 mg/m2iv d1~3,至少2周期进行评价。结果本组患者总有效率为46.67%;III期及IV期与复发转移者比较疗效均无显著性差别;鳞癌与腺癌比较疗效无显著性差异。毒性反应以骨髓抑制为主,III~IV度白细胞减少发生率61.82%,其中粒细胞减少性发热30.91%。其它不良反应耐受性良好。结论GP方案是治疗晚期非小细胞肺癌有效、耐受性良好的方案。     

国产吉西他滨联合卡铂治疗老年晚期非小细胞肺癌的临床观察

目的:观察国产吉西他滨联合卡铂治疗老年人晚期非小细胞肺癌(NSCLC)的临床疗效和不良反应。方法:64例患者随机分为两组:A组:吉西他滨1000mg/m²于第1,8天静脉滴注,卡铂(CBP)300mg/m²静脉滴注,第1天。每28天为1周期。B组:CBP300mg/m²静脉滴注,第1天,足叶乙甙(VP-16)80mg/m²于第1～3天静脉滴注,每28天为1周期。治疗2周期后评价疗效和不良反应。结果:64例患者中可评价疗效病例61例。A组30例中,14例(46.7%)达PR;B组31例中,7例(22.5%)达PR,A组疗效显著高于B组(P<0.05)。第二周期后有62例患者可评价不良反应。最常见的不良反应为骨髓抑制,Ⅲ～Ⅳ度血小板和白细胞下降发生率A组分别为22.6%和32.3%,B组均为12.9%。其余不良反应轻微,可耐受。结论:国产吉西他滨联合卡铂治疗老年人晚期非小细胞肺癌(NSCLC)是有效安全的。     

吉西他滨联合卡铂治疗老年非小细胞肺癌21例临床观察

目的：观察吉西他滨(GEM)联合卡铂(CBP)治疗老年(65岁以上)晚期非小细胞肺癌(NSCLC)的疗效及其毒副作用方法：对21例Ⅲ期～Ⅳ期老年(中位年龄71岁)晚期NSCLC给予GEM 800mg／m^2，静脉滴注、第1天，第8天，第15天，CBP350mg／m^2，静脉滴注，第2天，28天为1周期，至少用2周期后，按WHO实体瘤标准评价疗效。分为完全缓解(CR)、部分缓解(PR)、无变化(NC)、进展(PD)，毒副作用分为0度～Ⅳ度。结果：CR1例，RP10例。NC6例，PD4例，总有效率(CR PR)52.4％；毒副作用：白细胞下降占61.9％，但多为Ⅰ度～Ⅱ度，Ⅲ度～Ⅳ度者较少；血小板下降占23．8％，血红蛋白下降占28．6％，以Ⅰ度～Ⅱ度为多；胃肠反应52．4％，均为Ⅰ度～Ⅱ度，无Ⅲ度～Ⅳ度者；肝肾功能损害也较少。经升血及对症处理均未影响化疗完成，患者耐受好。结论：GEM联合CBP治疗老年及高龄晚期NSCLC疗效较好，毒副作用小，患者耐受好，是一个较理想的化疗方案。     

吉西他滨联合卡铂治疗老年晚期非小细胞肺癌疗效观察

非小细胞肺癌患者中老年病例几乎占 5 0 % ,而且75 %～ 80 %的患者就诊时已属于晚期 ,因而全身化疗在其治疗中占有很重要的地位。由于老年患者对化疗耐受性差 ,化疗方案的选择应注意患者的耐受性和生活质量。吉西他滨 (健择 ,Ｇｅｍｃｉｔａｂｉｎｅ)是阿糖胞苷类药物 ,属抗代谢类抗癌药 ,是近年来被临床证明治疗老年非小细胞肺癌的高效、低毒性的化疗药物[1,2 ] 。自2 0 0 0年 7月至 2 0 0 2年 6月我科用健择联合卡铂治疗34例老年晚期非小细胞肺癌患者 ,取得较好疗效 ,现报告如下。1　资料与方法1.1　临床资料　 34例均是经病理组织或细胞…     

吉西他滨联合卡铂治疗老年非小细胞肺癌的临床观察

目的：观察吉西他滨联合卡铂在晚期老年非小细胞肺癌（NSCLC）中的疗效和毒性。方法：2003年5月～2006年4月共40例患者人组,中位年龄74岁（65～84岁）。治疗方案：吉西他滨1100mg/m^2 d1、d8,卡铂（AUC=4）,d1,3周重复。观察治疗效果和不良反应以及不同分期及体力状态对生存期的影响。结果：40例患者共完成化疗128个周期。采用意向性分析（ITT）,获PR16例,SD15例,PD15例。中位生存时间和1年生存率分别为9．2个月和37．5％。疾病分期和体力状态可能是独立的预后指标。主要毒副反应为骨髓抑制,包括白细胞降低、血小板降低和贫血。无治疗相关死亡。结论：该剂量吉西他滨联合卡铂的治疗方案在老年人NSCLC中疗效较好,毒副反应可耐受,值得临床进一步推广。     

吉西他滨联合奥沙利铂治疗老年晚期非小细胞肺癌临床观察

肺癌是当今常见的恶性肿瘤之一,其中非小细胞肺癌占80%以上,而非小细胞肺癌患者一半左右为65岁以上的老年人。我国老年肺癌发病率已经超过世界男性平均水平。老年患者确诊时大多为晚期,失去手术机会。化疗是治疗晚期非小细胞肺癌重要手段,过去我们常用单药化疗治疗老年患者,不良反应虽然小,但疗效也受影响。     

Phase II study of carboplatin-paclitaxel combination chemotherapy in elderly patients with advanced non-small cell lung cancer

BACKGROUND: More than 30% of cases of non-small cell lung cancer (NSCLC) arise in patients aged > or =70 years. The efficacy and safety of carboplatin-paclitaxel combination chemotherapy in elderly patients with advanced NSCLC were evaluated in a phase II trial. METHODS: Twenty-five patients aged > or =70 years (median, 76; range, 70-83) with chemotherapy-naive advanced NSCLC were enrolled between January 2001 and July 2003. Additional criteria included the presence of measurable lesions, an Eastern Cooperative Oncology Group performance status of 0 or 1, and adequate organ function. Patients received carboplatin at an area under the curve of 5 mg/ml/min and paclitaxel at 180 mg/m(2) on the first day of consecutive 3 week periods. RESULTS: The patients included four with stage IIIB, 19 with stage IV and two with recurrent disease. The median number of treatment cycles was three (range, 1-4). One complete response and six partial responses, yielding an objective response rate of 28%, were obtained. The median survival time was 12.3 months and the 1-year survival rate was 52%. Hematological toxicities of grade 3 or 4 included leukopenia (40%), neutropenia (68%) and anemia (4%). Non-hematological toxicities of grade 3 included arthralgia-myalgia (16%) and neuropathy (12%). The objective response rate for patients aged > or =75 years (n = 15) was 26%, and no evidence of excessive toxicity in these patients was apparent compared with those aged <75 years. CONCLUSION: The combination carboplatin-paclitaxel at these doses is a feasible treatment option with a favorable toxicity profile for fit elderly patients with advanced NSCLC.     

奈达铂治疗晚期非小细胞肺癌临床观察

目的:观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组(GN组)30例,吉西他滨1000mg/m2,第1、8天,静脉滴注30分钟,奈达铂80mg/m2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组(GP组)30例,吉西他滨1 000mg/m2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果:GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异(P>0.05);GP组胃肠道反应(80%)发生率明显高于GN组(56.7%)(P<0.05);两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显(P>0.05);血小板下降GN组(73.3%)较GP组(66.7%)显著(P>0.05),但无统计学差异。结论:吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。     

奈达铂治疗晚期非小细胞肺癌临床观察

目的：观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。方法：60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组（GN组）30例,吉西他滨1000mg/m^2,第1、8天,静脉滴注30分钟,奈达铂80mg/m^2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组（GP组）30例,吉西他滨1 000mg/m^2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m^2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果：GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异（P〉0.05）;GP组胃肠道反应（80%）发生率明显高于GN组（56.7%）（P〈0.05）;两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显（P〉0.05）;血小板下降GN组（73.3%）较GP组（66.7%）显著（P〉0.05）,但无统计学差异。结论：吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。     

单药周剂量与联合方案治疗老年晚期非小细胞肺癌的临床观察

目的：探讨单药周剂量与联合方案治疗老年晚期非小细胞肺癌的疗效、不良反应和对患者生活质量的改善 。方法：96例老年晚期非小细胞肺癌患者随机分为3组，进行静脉化疗。A组（P方案）30例，紫杉醇（PTX）60mg／m^2，d1，8，15。B组（PC方案）34例，紫杉醇（PTX）60mg／m^2，d1，8，15；顺铂（CDDP）30mg／m^2，d2～4。C组（PCb方案）32例，紫杉醇（PTX）60mg／m^2，d1，8，15；卡铂（CBP）按AUC（曲线下面积）=5计算剂量，d2。4周为1个周期，二个周期后评定疗效。结果：A组、B组和C组有效率分别为26．7％、55．9％和56．3％，1年生存率分别为39．7％、35．3％和47.2％．中位生存期分别为8个月、9个月和10个月。B组和C纽疗效显著高于A组（P〈0．05），而B组和C组疗效差异无统计学意义（P〉0．05），3组生存率差异无统计学意义（P〉0．05）。主要不良反应骨髓抑制、变态反应、脱发、口腔炎，3组相似，B组消化道反应发生率高（P〈0．05），C组生活质量改善显著高于A组和B组（P〈0．05），而A纽和B组间改善无统计学意义（P〉0．05）。结论：紫杉醇周剂量联合顺铂或卡铂方案治疗老年晚期非小细胞肺癌的疗效高于紫杉醇周剂量单药，不良反应可耐受，PCb方案改善患者生活质量优于P方案和PC方案。     

吉西他滨联合顺铂治疗晚期非小细胞肺癌46例报道

目的观察吉西他滨联合顺铂治疗晚期非小细胞肺癌临床疗效及不良反应.方法46例患者采用吉西他滨1g/m2,d1,8,15及顺铂90mg/m2分两天(d 2,3)化疗.28天为1周期,3周期评价疗效.结果46例可评价疗效和不良反应.初治病例RR 53.8%;复治病例35%.主要不良反应为骨髓抑制.结论吉西他滨联合顺铂治疗晚期非小细胞肺癌有效率较高,不良反应可以耐受.     

Standard thoracic radiotherapy with or without concurrent daily low-dose carboplatin in elderly patients with locally advanced non-small cell lung cancer: a phase III trial of the Japan Clinical Oncology Group (JCOG9812)

BACKGROUND: The purpose of this study was to evaluate whether radiotherapy with carboplatin would result in longer survival than radiotherapy alone in elderly patients with unresectable stage III non-small cell lung cancer (NSCLC). METHODS: Eligible patients were 71 years of age or older with unresectable stage III NSCLC. Patients were randomly assigned to the radiotherapy alone (RT) arm, irradiation with 60 Gy; or the chemoradiotherapy (CRT) arm, the same radiotherapy and additional concurrent use of carboplatin 30 mg/m(2) per fraction up to the first 20 fractions. RESULTS: This study was terminated early when 46 patients were registered from November 1999 to February 2001. Four patients (one in the RT arm, three in the CRT arm) were considered to have died due to treatment-related causes. The JCOG Radiotherapy Committee assessed these treatment-related deaths (TRDs) and the compliance with radiotherapy in this trial. They found that 60% of the cases corresponded to protocol deviation and 7% were protocol violation in dose constraint to the normal lung, two of whom died due to radiation pneumonitis. As to the effectiveness for the 46 patients enrolled, the median survival time was 428 days [95% confidence interval (CI) = 212-680 days] in the RT arm versus 554 days (95% CI = 331 to not estimable) in the CRT arm. CONCLUSIONS: Due to the early termination of this study, the effectiveness of concurrent use of carboplatin remains unclear. We re-planned and started a study with an active quality control program which was developed by the JCOG Radiotherapy Committee.     

改良吉西他滨联合卡铂治疗局部晚期老年性非小细胞肺癌的疗效观察

目的:评价改良国产吉西他滨联合卡铂治疗局部晚期老年性非小细胞肺癌的疗效及安全性。方法:对77例有明确的病理或细胞学检诊断,年龄在65岁-80岁之间的晚期ⅢB-Ⅳ期非小细胞肺癌(NSCLC)患者,应用国产吉西他滨联合卡铂化疗,用药方法为盐酸吉西他滨800mg/m2加生理盐水100m l,于30分钟内静脉滴注,第1、8、15天各1次,CBP按AUC=4,每28d为1个周期;共2-3三个周期。并按REC IST标准评价疗效和WHO毒副反应。结果:总有效率(CP PR)为48.05%(37/77);其中Ⅲ期28例,总有效率为36.36%;Ⅳ期9例,总有效率为11.69%,初治27例,总有效率为35.06%,复治10例,总有效率为12.99%。结论:国产盐酸吉西他滨是治疗晚期NSCLC的有效药物,使用安全,联合卡铂的疗效及不良反应可以接受。     

Gemictabine plus carboplatin in patients with advanced non-small cell lung cancer

To evaluate the efficacy and safety of gemictabine combined with carboplatin for a chemotherapy regimen for patients with metastatic, recurrent, or locally advanced non-small cell lung cancer (NSCLC), 46 chemotherapy-naïve patients with histologically confirmed stage IIIB or IV NSCLC were treated with 1250 mg/m² of gemictabine on d 1 and 8, with carboplatin of AUC 6 additionally applied on d 1. This treatment was repeated every 3 wk. In all, a total of 215 chemotherapy courses were administered. The median age of the patients was 46, ranging from 33 to 83. Ten patients (22%) had an ECOG performance status of 2. Responses were observed objectively in 20 patients (43.5%) and maintained for a median of 7.4 mo. The median duration of progression-free and overall survivals were 5.0 and 12.3 mo, respectively. Neutropenia was frequently encountered, and gastrointestinal side effects, such as anorexia and nausea, were mostly predictable but manageable. One patient died of septic shock due to a complication with pneumonia while simultaneously trying to recover from myelosuppression. A subgroup consisting of patients aged 65 yr or older and/or PS 2 showed a outcome similar with the entire group of all patients involved in the study: response rate (43.5%), median PFS (4.6 months), median OS (12.3 months), and similar toxicity rate. After analyzing all the results, it was evident that a treatment of gemcitabine combined with carboplatin is an active and safe regimen for first-line treatment of advanced NSCLC. The results of the elderly and/or PS 2 patients were similar to those of the entire group of patients.