单药周剂量与联合方案治疗老年晚期非小细胞肺癌的临床观察

目的：探讨单药周剂量与联合方案治疗老年晚期非小细胞肺癌的疗效、不良反应和对患者生活质量的改善 。方法：96例老年晚期非小细胞肺癌患者随机分为3组，进行静脉化疗。A组（P方案）30例，紫杉醇（PTX）60mg／m^2，d1，8，15。B组（PC方案）34例，紫杉醇（PTX）60mg／m^2，d1，8，15；顺铂（CDDP）30mg／m^2，d2～4。C组（PCb方案）32例，紫杉醇（PTX）60mg／m^2，d1，8，15；卡铂（CBP）按AUC（曲线下面积）=5计算剂量，d2。4周为1个周期，二个周期后评定疗效。结果：A组、B组和C组有效率分别为26．7％、55．9％和56．3％，1年生存率分别为39．7％、35．3％和47.2％．中位生存期分别为8个月、9个月和10个月。B组和C纽疗效显著高于A组（P〈0．05），而B组和C组疗效差异无统计学意义（P〉0．05），3组生存率差异无统计学意义（P〉0．05）。主要不良反应骨髓抑制、变态反应、脱发、口腔炎，3组相似，B组消化道反应发生率高（P〈0．05），C组生活质量改善显著高于A组和B组（P〈0．05），而A纽和B组间改善无统计学意义（P〉0．05）。结论：紫杉醇周剂量联合顺铂或卡铂方案治疗老年晚期非小细胞肺癌的疗效高于紫杉醇周剂量单药，不良反应可耐受，PCb方案改善患者生活质量优于P方案和PC方案。

Weekly Single-Agent Versus Combination Chemotherapy for elderly patients with advanced non--small cell lung cancer

Objective: To evaluate the efficacy, side effects and improving the quality of life of single-agent versus combination chemotherapy in elderly patients with advanced non--small cell lung cancer(NSCLC). Methods: Ninety-six chemotherapy-naive elderly patients with advanced NSCLC were randomly assigned to three groups, and received chemotherapy every 28 days for 2 cycles. Thirty patients received P ( PTX 60mg/m2, d1,8,15) in group A. Thirty-four patients received PC (PTX 60mg/m2,d1,8,15; CDDP 30mg/m2, d2~4) in group B. Thirty-two patients received PCb (PTX 60mg/m2,d1,8,15; CBP at an AUC of 5, d2.) in group C. Results: The objective response rate was 26.7%, 55.9% and 53.1% in groups A, B and C , respectively. One-year survial rate was 39.7%, 35.3% and 47.2%, and median survival was 8 months, 9 months and 10 months in groups A, B and C, respectively. The efficacy of groups A and B was better than that of group C (P<0.05), but there was no significant defference between group A and group B (P>0.05). One-year survial rate was not statistically different among three groups(P>0.05). The major side effects, including myelosuppression, stomatitis, allergy and alopecia, were similar in three groups, but nausea/vomiting were more obvious in group B relatively(P<0.05). Improving the quality of life of group C was better than that of groups A and B(P<0.05), without any significant defference between group A and group B (P>0.05). Conclusion: The therapeutic effect of combination chemotherapy in elderly patients with advanced NSCLC was better than that of single agent, and side effects were tollerable. Improving quality of life of PCb regimen was better than that of P regimen and PC regimen.