吉西他滨单药或联合卡铂治疗老年晚期非小细胞肺癌疗效观察

 目的 评价吉西他滨单药或与卡铂联合对老年晚期非小细胞肺癌(NSCLC)化疗的安全性和可行性.方法 48例年龄≥65岁的晚期NSCLC患者随机分为单药治疗组和联合用药组.单药治疗组:盐酸吉西他滨1000 mg/m2,静脉滴注,第1、8天,21 d为一疗程.联合用药组:吉西他滨1000 mg/m2,静脉滴注,第1、8天;卡铂,第1天,以AUC=5计算所得的剂量静脉滴注.21 d为一疗程.结果 单药治疗组有效率为20.8%;联合用药组有效率33.3%,两组有效率差异有统计学意义(P＜0.05).单药治疗组中位生存期8.2个月,1年生存率32.1%.联合用药组中位生存期9.6个月,1年生存率为39.4%;两组1年生存率比较,差异无统计学意义(P＞0.05).联合用药组3～4级白细胞和血小板减少发生率均显著增高(P＜0.05),但粒细胞减少性发热、感染及出血的发生率并没有显著增加.结论 吉西他滨单药或吉西他滨联合卡铂均是治疗老年晚期NSCLC的较好方案,不良反应均可耐受.

Gemcitabine alone versus gemcitabine plus carboplatin in treatment of elderly patients with advanced non-small cell lung cancer

Objective To compare the efficacy and toxicity of gemcitabine and gemcitabine plus carboplation in treatment of elderly patients with locally advanced or metastatic non-small-cell lung cancer(NSCLC).Methods 48 eligible patients above 65 years old who had previously been left untreated and were in stageⅢB orⅣNSCLC were randomly assigned to receive either gemcitabine alone(1000 mg/m~2 on days land 8 ) or gemcitabine plus carboplatin(area under the curve 5 on day 1 ) every 21 days. Results The overall response rate was 20.8%in gemcitabine group and 33.3%in gemcitabine with carboplatin group,respectively (P<0.05).The median overall survival time was 8.2 months in gemcitabine group and 9.6 months in gemcitabine with carboplatin group(P>0.05 ).The 1-year overall survival rate was 32.1%in gemcitabine group and 39.4%in gemcitabine with carboplatin group,respectively(P>0.05 ).The frequency of grades 3 to 4 leucopenia and thrombocytopenia was significantly higher in the gemcitabine with carboplatin group(P for both variables<0.05 ) but without associated increase in fever,infection or bleeding. Conclusion In advanced NSCLC,the single gemcitabine or gemcitabine plus carboplatin is tolerable and effective for elderly patients with advanced stages ⅢB and Ⅳ NSCLC.