长春瑞滨与紫杉醇联合铂类治疗老年晚期非小细胞肺癌临床对照研究

Clinical study of vinorelbine and paclitaxel plus platinum for treatment of elder advanced non-small cell lung cancer

目的观察比较长春瑞滨与紫杉醇加顺铂及卡铂联合方案治疗老年晚期非小细胞肺癌(NSCLC)的临床疗效和毒副反应.方法 76例年龄≥70岁的老年晚期NSCLC患者分别应用NP(长春瑞滨+顺铂)、NC(长春瑞滨+卡铂)及TC(紫杉醇+卡铂)方案化疗.每例患者至少完成2周期后评价疗效及毒副反应.3组患者一般特征具有可比性(P＞0.05).结果 3组患者有效率分别为NP组32.4%、NC组33.3%、TC组37.5%,3组间有效率比较差异无显著性(χ2=0.177,P＞0.05).NP组中位生存期10个月,1年生存率38.7%;NC组中位生存期10.25个月,1年生存率41.7%;TC组中位生存期12.5个月,1年生存率57.7%,3组间比较差异有显著性(χ2=12.66,P=0.0018).3组主要毒副反应为骨髓抑制及消化道反应,NP、NC、TC组Ⅲ～Ⅳ度白细胞减少发生率分别为46.4%、33.3%和58.3%(χ2=4.180,P＞0.05);NP组Ⅲ～Ⅳ度消化道反应较NC组及TC组明显,分别为14.3%、8.3%和4.2%(χ2=0.831,P＞0.05).3组病例均无化疗相关死亡发生.结论 NP、NC、TC联合方案是治疗老年晚期NSCLC有效且耐受性较好的方案.

Objective To evaluate the efficacy and toxicity of combined chemotherapy of vinorelbine and paclitaxel pins cisplatin and carboplatin in the treatment of elder advanced non-small cell lung cancer （NSCLC）. Methods Seventy-six elder patients （≥ 70 years）with advanced NSCLC were enrolled in this study and treated by NP （vinorelbine plus cisplatin）, NC（vinorelbine plus carboplatin） and TC（pachtaxel plus carboplatin）. The efficacy and side effects were analysed after at least two cycles of chemotherapy. Patients in three groups were wellmatched with baseline disease characteristics（ P 〉 0.05）. Results The overall response rates were 32.1% in the NP group, 33.3% in the NC group and 37.5% in the TC group respectively. No significant statistical difference was found among the three groups（X^2 = 0.177, P 〉 0.05） .The median survival times and the 1-year survival rates were 10 months,38.7%;10.25 months,41.7% and 12.5 months,57.7% respectively in the NP, NC and TC groups.The statistical difference was found among the three groups significantly（X^2 = 12.66, P = 0.0018）.The major side effects were myelosuppression, nansea/vomiting in the three groups. Grade Ⅲ-Ⅳ leukopenia occourred in 46.4% ,33.3%,58.3% respectively in the NP, NC and TC groups（X^2 =4.180,P〉 0.05）. Grade m nausea/ vomiting were more serious in NP group than in NC and TC groups（X^2 = 0.831, P 〉 0.05 ）. There were no chemotherapy-related death among the three groups. Conclusion The combined regimens of NP, NC and TC are effective and well-tolerated regimens for elder advanced NSCLC.