GP方案与吉西他滨单药治疗老年人晚期非小细胞肺癌的疗效比较

 目的　比较GP方案与吉西他滨（GEM）单药治疗老年人晚期非小细胞肺癌（NSCLC）的近期疗效、生存状况及不良反应。方法　85例老年Ⅲ～Ⅳ期NSCLC患者按照起始治疗方案的不同分为GP组（43例）及GEM组（42例）。GP组接受GEM 1.0 g／m2第1、8天＋顺铂（DDP）75 mg/m2第2天至第4天治疗, GEM组接受GEM 1.25 g／m2第1、8天化疗。两组均治疗3周为1个周期，至少2个周期后按实体瘤疗效评价标准（RECIST）评价近期疗效及生存状况，评价不良反应。结果　GP组和GEM组治疗有效率分别为48.84 %（21／43）和35.71 %（15／42），差异无统计学意义（χ2＝1.708，P＝0.424）。GP组1年生存率39.53 %（17／43），2年生存率9.30 %（4／43），中位生存时间（MST）为11个月；GEM组1年生存率26.19 %（11／42），2年生存率7.14 %（3／42），MST为9个月， 两组中位生存时间比较差异无统计学意义（t＝1.377，P＝0.172）。GP组恶心、呕吐发生率（34.88 %）较GEM组（7.14 %）高，差异有统计学意义（χ2＝9.796，P＝0.002），其他不良反应两组接近，患者可耐受。结论　对于老年晚期NSCLC患者，GP方案和GEM单药化疗疗效相当，不良反应接近，GEM单药的胃肠道反应更轻。

Efficacy comparison of GP regimen or gemcitabin treated for elderly patients with advanced nonsmall-cell lung cancer

Objective To evaluate and compare the efficacy and toxicity of gemcitabin（GEM） plus cisplantin and GEM on the chemotherapy of elderly patients advanced non-small-cell lung cancer （NSCLC）. Methods 85 elderly patients with stage 3 to 4 NSCLC were randomized into gemeitabine plus cisplatin （group GP） and GEM （group GEM）. In group GP, patients received GEM on day 1 and day 8 at dose 1.0 g/m^2, add cisplatin on day 2 to day 4 at dose 75 mg/m^2. In group GEM, patients would received single GEM at dose 1.25 g/m^2. The the therapy circle was 3 weeks and undertaken least 2 circles before the treatment efficacy and survival would be evaluated according RECIST. Results In GP group the response rate was 48.84 %（21/43）, In GEM group the response rate was 35.71%（15/42）, the difference of response rate between two groups was not statistically signifieant（χ^2=1.708, P=-0.424）.The median survival were 11 months to Gp group and 9 months to GEM group. The 1 year survival rates of GP group were 39.53 % and of GEM group were 26.19 %. The survival time between two groups was not statistically significant（χ^2=-1.377, P=0.172）. The same toxicity in both groups was defected, Nausea and vomiting occurred were more serious in GP group than that in GEM group （χ^2=9.796, P=0.002）. Conclusion GP and GEM are both effective for treatment of elderly advanced NSCLC.There are no significantly differences on efficacy and toxicity in 2 groups. Side effects on alimentary system are obviously less in GEM group than that in GP group.