多西他赛一线治疗老年晚期非小细胞肺癌的临床观察

目的:观察多西他赛单药治疗老年晚期非小细胞肺癌(NSCLC)的疗效。方法:选择2007年1月-2010年7月我院收治的高龄、晚期NSCLC患者97例,双盲法随机分为A、B组。A组(48例)使用多西他赛单药治疗,多西他赛单药60～75mg·m-2溶于0.9%氯化钠溶液250mL中静脉滴注1h,于第1天或者分于第1、8天给药。B组(49例)使用多西他赛联合顺铂治疗,多西他赛用法同A组;顺铂60～80mg·m-2溶于250mL0.9%氯化钠溶液中静脉滴注,于第1天或者分于第1、2、3天给药并给予水化。2组患者均21d为1个周期。治疗2～4个周期。观察2组的有效率、生存率及不良反应。结果:所有患者均完成2个周期以上化疗,A组总有效率为37.5%,1年生存率为52.1%;B组总有效率为38.8%,1年生存率为53.1%,2组比较差异无统计学意义(P>0.05)。B组粒细胞减少性发热、恶心、呕吐、肝肾功能异常的发生率均明显高于A组(P<0.01或P<0.05)。结论:多西他赛单药治疗老年晚期NSCLC与联合顺铂治疗疗效无明显差异,但毒性反应轻,安全性较好。

Clinical Observation of Docetaxel First Line Treatment of Senile Advanced Non-small Cell Lung Cancer

OBJECTIVE:To observe therapeutic efficacy of docetaxel in treatment of senile advanced non-small cell lung cancer (NSCLC). METHODS:Totally 97 patients with aged and advanced NSCLC in our hospital during Jan. 2007-Jul. 2010 were divided into 2 groups randomly. 48 cases in group A were treated with docetaxel 60～75 mg·m-2 dissolved in 0.9% sodium chloride 250 mL for intravenous injection at the first day or at the first day or at the eighth day. 49 cases in group B were treated with docetaxel and cisplatin, treatment of docetaxel was same to that of group A. Cisplatin 60～80 mg·m-2 dissolved in 0.9% sodium chloride 250 mL for intravenous injection. At the first day or at the first, second and third day, group B was given medicine and hydratation. 21 days were a course and 2 groups received 2～4 treatment courses. The effective rate, survival rate and side effect of 2 groups were observed. RESULTS:All the patients completed the chemotherapy 2 cycles or over. The total effective rate of group A was 37.5%, 1-year survival rate was 52.1%, the total effective rate of group B was 38.8%, 1-year survival rate was 53.1%, there was no statistical difference between 2 groups (P>0.05). The incidence of granulocytopeniac fever and nausea and liver kidney function abnormality of group B were higher than those of group A (P<0.01 or P<0.05). CONCLUSIONS:Docetaxel alone and docetaxel combined with cisplatin have no significant difference in therapeutic efficacy in the treatment of NSCLC, but docetaxel alone has less toxic side effect and sound safety.