长春瑞滨治疗27例高龄晚期非小细胞肺癌

Single agent vinorelbine for the treatment of advanced non-small-cell lung cancer in 27 elderly patients

目的:探讨单药长春瑞滨治疗70岁以上高龄晚期非小细胞肺癌患者的疗效及毒副反应.方法:2002年9月至2004年9月采用长春瑞滨治疗70岁以上高龄晚期非小细胞肺癌(NSCLC)27例,长春瑞滨25～30 mg/m2+60ml生理盐水稀释,静注第1、8天,21天为1个周期,一般3～4周期,共进行了92周期.观察近期疗效、远期疗效、不良反应、中位缓解期和中位生存期.结果:PR 9例,NC 10例,PD 8例,总有效率33.3%.中位缓解期4.1个月,中位生存期10.3个月.白细胞减少发生率为55.4%(51/92),Ⅲ/Ⅳ度为18.5%(17/92),血小板减少率为8 7%(8/92),静脉炎发生率为6.5%(6/92).结论:长春瑞滨在治疗高龄晚期NSCLC患者中,有较好的近期疗效,毒副反应可耐受,临床应用安全,可以作为高龄晚期非小细胞肺癌的治疗方案选择之一.

Purpose： To evaluate the efficacy and toxieity profile of single agent vinorelbine in elderly patients（ 〉 or = 70 years of age） with advanced non-small-cell lung cancer. Methods： From September 2002 to September 2004, 27 eld- erly patients （ 〉 or = 70 years of age） with advanced non-small-cell lung cancer were enrolled. Median age was 75.3 years （ range： from 70 to 86）. Karnofsky performance score was 90, 80, 70, 60, or 50 in 3.7%, 25.9%, 29.6%, 37.0%, and 3.7% of patients respectively. Vinorelbine was administered at the dose of 25-30 mg/m^2, i. v., day 1 and day 8, every 3 weeks. There were 92 cycles in total. The short-term response, long-term outcome, adverse reaction, median duration of response and median survival status were observed. Results： There were 9 partial responses , 10 no changes and 8 progressive diseases. The total efficiency rate is 33.3%. The median durations of response and survival were 4.1 and 10.3 months respectively. The main toxicity were （ % of patients） ： grade Ⅲ/Ⅳ neutropenia 18.5% ; thrombocytopenia 8.7% ; phlebitis 6.5%. Conclusions： The study suggests that single agent vinorelbine is active , safe and well-tolerated in elderly patients （ 〉 or = 70years of age） with advanced non-small-cell lung cancer. Single agent vinorelbine should be selective ehemothe〉 apy in elderly patients with advanced non-small-cell lung cancer.