含顺铂方案治疗老年晚期非小细胞肺癌的临床分析

目的探讨吉西他滨(GEM)联合顺铂(DDP)方案及长春瑞滨(NVB)联合DDP方案在治疗老年晚期非小细胞肺癌的临床效果及毒性反应。方法63例晚期老年非小细胞肺癌患者随机分为两组,吉西他滨组31例,长春瑞滨组32例。分别评价其疗效。结果吉西他滨组完全缓解(CR)2例,部分缓解(PR)11例,有效率为41.94%。长春瑞滨组完全缓解(CR)3例,部分缓解(RP)11例,有效率43.75%。两组间差异无显著性(χ2=0.02,P>0.05)。中位生存期吉西他滨组为9.3个月,长春瑞滨组为9.5个月,中位缓解期吉西他滨组为4.3个月,长春瑞滨组为4.4个月。毒性反应:吉西他滨组白细胞Ⅲ/Ⅳ度下降发生率为12.90%,长春瑞滨组白细胞Ⅲ/Ⅳ度下降发生率为34.38%,长春瑞滨组明显高于吉西他滨组(χ2=4.00,P<0.05);吉西他滨组血小板Ⅲ/Ⅳ度下降4例,发生率为12.90%,明显高于长春瑞滨组(χ2=4.41,P<0.05);长春瑞滨组发生外周静脉炎6例,发生率为18.75%,明显高于吉西他滨组(χ2=5.42,P<0.05)。结论吉西他滨联合顺铂与长春瑞滨联合顺铂治疗老年晚期非小细胞肺癌的近期临床效果相近,中位生存期及中位缓解期相似,一般状况良好(KPS≥70分)的老年患者能够耐受。

Cisplatin - based regimens for treatment elderly patients with non- small cell lung cancer

Objective evaluate the clinical effects and safety of GP(gemcitabine +DDP) regimen and NP(navelbine+DDP) regimen for elderly patients with non-small cell lung cancer.Methods 63 elderly patients with non-small cell lung cancer were randomly allocated to GEM group(GP regimen group,n=31) and NVB group(NP regimen group,n=32).Their clinical effects were compared respectively.Results With overall response rate of 41.94% for GEM group,of 2 cases had a complete response,of 11 cases had a partial response.With overall response rate of 43.75% for NVB,of 3 cases had a complete response,of 11 cases had a partial response.There were no statistically significant differences between these two groups(χ~2=0.02,P>0.05).The mean survival time was 9.3 months and 9.5 months in GEM group and NVB group,respectively;the mean remission time was 4.3 months and 4.4 months in GEM group and NVB group,respectively.Toxicity: 12.90% of patients in GEM group had grade Ⅲ/Ⅳ leukopenia and 34.38% of patients in NVB group had grade Ⅲ/Ⅳ leukopenia,in comparison to GEM group,there was statistically significant difference(χ~2=4.00,P<0.05);in GEM group,4 cases(12.90%) had grade Ⅲ/Ⅳ thrombocytopenia,which was higher than NVB group(χ~2=4.41,P<0.05);6 patients(18.75%) in GEM group had peripheral phlebitis,which was higher than that in GEM group(χ~2=5.42,P<0.05).Conclusion GP regimen and NP regimen had similar clinical results in treatment elderly patients with non-small cell lung cancer,which had similar mean survival time and mean remission time.Chemotherapy would be well-tolerated by elderly patients with KPS≥70.