非小细胞肺癌老年与中青年患者的对照临床分析

目的探讨老年与中青年非小细胞肺癌患者临床特征与治疗特点。方法对北京协和医院肿瘤内科2002年5月至2010年12月收治的晚期非小细胞肺癌老年组(≥70岁,101例)与中青年组(≤60岁,127例)的化疗强度、效果和毒副反应进行分析。主要研究指标是疾病控制率、客观有效率、到疾病进展时间,次要研究指标是内科合并症、化疗毒副反应。结果老年组合并症多于中青年组(87.1%vs.28.3%,P<0.05)。一线化疗中青年组比老年组疾病控制率(56.1%vs.58.2%)、客观有效率(13.4%vs.9.1%)有显著性差异,到疾病进展时间无显著差异(6.0个月vs.5.1个月)。血液学毒性老年组与中青年组相当(28.4%vs.21.1%,P>0.05),老年组心脑血管及肝肾并发症、系统性感染多于中青年患者(44.3%vs.10.9%,P<0.05)。结论年龄因素并不影响化疗疗效及增加血液学毒副反应,老年患者需要更加关注心脑血管及肝肾并发症、预防感染。

A comparison clinical analysis in elderly and young patients with non-small cell lung cancer

Objective To compare the clinical characteristics and efficacy of chemotherapy of elderly patients with young patients with non-small cell lung cancer(NSCLC).Methods A retrospective survey was conducted in 101 elderly patients and 127 young patients suffered from NSCLC.Main points included DCR、ORR、TTP,and complications.The effects and toxicities between the two groups were compared.Results The elderly patients had more complications than young patients(87.1% vs.28.3%,P < 0.05).The difference of DCR(56.1% vs.58.2%)、ORR(13.4% vs.9.1%) of first-line chemotherapy in the two groups were statistically significant.Grade 3～4 blood toxicity were 28.4% and 21.1% respectively(P > 0.05).The non-hematological toxicities in the two groups were 44.3% and 10.9% respectively(P < 0.05).Conclusion Appropriate chemotherapy may be well tolerated by elderly patients,but special attention should be paid to non-hematological toxicities.