吉西他滨单药及联合顺铂治疗老年非小细胞肺癌临床疗效观察

目的本研究旨在分析年龄≥70岁的晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者使用吉西他滨联合铂类化疗或吉西他滨单药化疗的疗效和毒性。方法选取≥70岁Ⅱ～Ⅳ期不能手术，并且东部肿瘤协作组（eastern cooperative oncology group，ECOG）体力状态评分（performance status，PS）为0～1分的NSCLC患者83例，仅用吉西他滨的单药化疗组40例，吉西他滨联合顺铂的联合化疗组43例，主要的研究终点为无进展生存期（progression free survival，PFS）。结果单药组患者平均年龄（74．75±1．72）岁，29例（占72.5％）患者有合并症，平均完成4．65个周期化疗。总有效率（overall response rate，ORR）为25％，疾病控制率（disease control rate，DCR）为70％，PFS为4月；联合组平均年龄（75．72±1．29）岁，28例（占65．1％）患者有合并症，平均完成4．02个周期化疗。ORR为39．5％，DCR为79．1％，PFS为6月。2组间差异有统计学意义（P〈0．05）。联合组不良反应更重。结论联合组疗效优于单药组，但Ⅲ-Ⅳ度不良反应发生率也较单药组高。吉西他滨联合铂类化疗在具有良好体力状态的≥70岁老年人是一种有效的治疗方案，并且具有可接受的毒性水平。

Clinical efficacy of gemcitabine plus cisplatinum in comparison with gemcitabine alone in the elderly patients with advanced non-small cell lung cancer

Objective To analyze the efficacy and toxicity of gemcitabine plus cisplatinum in comparison with gemcitabine alone in the patients aged 70 years and over with advanced non-small cell lung cancer （NSCLC）. Methods The data of 83 patients with histologically or cytologically confirmed NSCLC, staged Ⅱ ,Ⅲ or Ⅳ ,aged 70 years and over, and with an Eastern Cooperative Oncology Group Performance status 0 or 1 were retrospectively analyzed. Forty of them received gemcitabine, and forty-three received gemcitabine plus cisplatin. The primary endpoint was progression free survival （PFS）. Results The average age of the patients in gemcitabine alone group was 74. 75 ± 1.72 years, compared with 75.72 ± 1.29 years in gemeitabine plus cisplatinum （GC） group. Twenty-nine （72. 5% ） patients in gemcitabine alone group and 28 （65.1%） in GC group had at least one comorbidity. The mean number of treatment cycles completed Was 4. 65 and 4.02 respectively in gemeitabine alone group and GC group. Overall response rate （ORR） , disease control rate（DCR） and median progression-free survival （PFS） were 25%, 70% and 4.45 months in gemeitabine alone group, compared with 39. 5%, 79. 1% and 6. 60 months respectively in GC group. A statistically significant difference in efficacy was observed in favor of GC group, though the rate of adverse events staged Ⅲ or Ⅳ was also higher in GC group than those in gemcitabine alone group. Conclusions Gemcitabine plus cisplatinum may be considered as an effective option with an acceptable tox- icity in chemotherapy for advanced NSCLC in the patients aged 70 years and over with good performance status.