紫杉醇联合奥沙利铂与紫杉醇联合顺铂治疗老年晚期非小细胞肺癌疗效观察（附72例）

目的：观察和比较紫杉醇（PTX）联合奥沙利铂（L—OHP）与紫杉醇联合顺铂（DDP）治疗老年晚期非小细胞肺癌的疗效及不良反应。方法：经病理组织学或细胞学确诊为晚期非小细胞肺癌的老年患者（年龄≥70岁）72例为研究对象，分为紫杉醇联合奥沙利铂（PO）组及紫杉醇联合顺铂（PC）组，紫杉醇给予周剂量60mg／m^2，第1、8、15天静脉滴注3h，紫杉醇用药前1h、30min分别静推地塞米松10mg，用药前30min肌注非那根25mg，静滴西米替丁doing以预防过敏反应；奥沙利铂65mg／m^2，第1、8天静脉滴注2h；顺铂25mg／m^2，第1—3天静脉滴注；28天为1周期，每例患者至少治疗2周期以上，按照RECIST标准评价疗效和不良反应。结果：PO组35例：完全缓解（CR）1例，部分缓解（PR）10例，稳定（sD）14例，总有效率为31．4％；PC组37例：完全缓解0例，部分缓解10例，稳定13例，总有效率为27．0％；最常见的不良反应为骨髓抑制、消化道反应、肾功能损害、神经毒性等，其中P0组的神经毒性发生率显著高于PC组；PC组Ⅲ-Ⅳ度胃肠道反应和肾毒性显著多于PO组。结论：PO方案与PC方案治疗老年晚期非小细胞肺癌的疗效相似，但PO方案较PC方案的不良反应轻，老年患者更容易耐受，是老年晚期非小细胞肺癌较理想的化疗方法。

Study of paclitaxel in combination with oxaliplatin and with cisplatin in treatment of elderly patients with advanced non -small cell lung cancer

Objective：To observe and compare the efficacy and toxicity of paclitaxel （PTX） in combination with oxaliplation（ L - OHP） and with cisplatin（DDP） in the treatment of elderly patients with advanced non - small cell lung cancer（NSCLC）. Methods ： Total of 72 elderly patients （ age t〉 70 ） with advanced NSCLC diagnosed pathologically were divided into PO or PC（ paclitaxel 60mg/m2 iv drip for 3 hours on d1,8,15 and oxaliplation 65mg/m2 iv drip for 2 hours on d1,8 or eisplatin 25 mg/m2 iv drip on d1,2,3 ,dexamethasone 10mg iv 1 hour,30 minutes and promethazine 25mg in 30 minutes and cimetidine 40mg iv 30 minutes before using paelitaxel）. Each patients was given 2 cycles at least. The chemotherapy was repeated every 28 days and the efficacy and toxicity were then evaluated. Results：Thirty five cases could be evaluated in PO group and 37 cases in PC group. In PO group, the overall response rate was 31,4% and 27.0% in PC group. The major toxic reactions in two groups were marrow depression, gastroin- testinal reaction,renal toxicity and neurotoxicity. Conclusion：The efficacy is similar for 2 projects in the treatment of elderly patients with advanced NSCLC. Marrow depression between two groups is not significant different, Neurotoxicity is more in PO group. Gastrointestinal reaction and renal toxicity are more in PC group. PO project is better tolerated than PC project.