白蛋白结合型紫杉醇一线治疗40例晚期肺鳞癌的观察

  目的  观察白蛋白结合型紫杉醇（NAB-P）一线治疗老年晚期肺鳞癌患者的疗效、不良反应及预后因素。  方法  前瞻性设计收集2012年12月至2015年12月福建医科大学附属第二医院入组40例老年晚期肺鳞癌患者，给予注射用NAB-P方案一线化疗，具体化疗方案为:NAB-P 260 mg/m2，静滴d1，3周为1个疗程，每2个周期后评价疗效。  结果  40例患者均可评价疗效及获得随访，其中完全缓解（complete response，CR）2例，部分缓解（partial response，PR）13例，稳定（stable disease，SD）13例，进展（progression disease，PD）12例，客观缓解率（objective response rate，ORR）为37.5%，疾病控制率（disease control rate，DCR）为70.0%；无进展生存期（progression-free survival，PFS）为6.3个月、总生存期（overall survival，OS）为12.6个月、1年生存率为62.5%；血液毒性方面中性粒细胞减少及贫血较为常见，非血液毒性主要为乏力、便秘、恶心、呕吐、肌肉酸痛、脱发，大部分患者均能耐受上述不良反应；肿瘤分期、体力状况评分（ECOG）、有效率和PFS是影响老年患者生存的独立预后因素（P < 0.05），而年龄与患者的预后无关（P>0.05）。  结论  NAB-P单药一线治疗老年晚期肺鳞癌有较好的疗效和安全性。 

Observation of nab- paclitaxel as first- line treatment in 40 elderly patients with advanced lung squamous carcinoma

  Objective  To evaluate the clinical efficacy, toxicity, and prognostic factors of nab-paclitaxel as first-line treatment for elderly patients with advanced lung squamous carcinoma.  Methods  This was a prospective study. Forty patients enrolled in the Second Affiliated Hospital of Fujian Medical University were treated with nab-paclitaxel (260 mg/m2, ivggt d1), and a period of three weeks was considered as one session. The effects were evaluated after two cycles.  Results  All 40 patients were followed up and appraised. Two patients achieved complete remission, 13 achieved partial remission, 13 achieved stable disease, and 12 achieved progressive disease. The objective response rate was 37.5% and the disease control rate was 70.0%. The progression-free survival (PFS), median overall survival, and 1-year survival rate was 6.3 months, 12.6 months, and 62.5%, respectively. The main hematologic toxicities were neutropenia and anemia, and the main non-hematologic adverse events were fatigue, constipation, nausea, vomiting, muscle aches, and hearing loss. Most patients could tolerate these toxic reactions. Moreover, Cox multivariate regression analysis showed that the neoplasm stage, Eastern Cooperative Oncology Group performance status, response rate, and PFS were independent factors for the survival rate (P < 0.05), while age was not related to patient prognosis (P>0.05).  Conclusions  Nab-paclitaxel as single drug and first-line therapy for elderly patients with advanced lung squamous carcinoma is effective and safe.