多西他赛联合卡铂治疗老年非小细胞肺癌临床观察

Promethazine in Combination with Carboplatin for Advanced Non-small-cell Lung Cancer in Elderly Patients: Observation of Clinical Efficacy

目的:观察多西他赛(多帕菲)治疗老年人晚期非小细胞肺癌的临床疗效及毒性反应。方法:多西他赛35mg.(m2)-1,d1,d8,d15,每次输注多西他赛之前30min应用地塞米松10mg静注,异丙嗪25mg肌注,雷尼替丁30mg静滴,卡铂400mg/次静滴,d1,休息2wk为1个周期,每28天重复。治疗2个周期评价疗效。结果:非小细胞肺癌36例,有12例患者部分缓解,在36例入组患者中有效率为33.3%,在32例可评价患者中有效率为37.5%。稳定13例,进展8例,未评价3例。主要毒性是骨髓抑制,尤以粒细胞减少为多见,Ⅲ+Ⅳ为13.2%。白细胞总数最低为2.4×109/L,在化疗后10～14天白细胞计数在最低点。其他化疗反应为乏力、恶心、食欲减退。结论:国产多西他赛治疗老年人晚期NSCLC有较好疗效,毒副反应小,价格相对便宜,是老年人治疗选择之一。

OBJECTIVE： To observe the efficacy and toxicity of promethazine in treating advanced non - small - cell lung cancer （NSCLC）. METHODS： Thirty- six elderly NSCLC patients received promethazine 35mg·（m^2）^-1 on day 1, 8 and 15, and 30min prior to each infusion, patients were administered with 10mg dexamethaseone i. v, 25mg promethazine i. m and 30mg ranitidine i. v drip, and carboplatin 400mg was administered by i. v drip only on day 1, followed by pause of two weeks. The schedule cycle was repeated every 28 days. The clinical responses were assessed after two cycles of treatment. RESULTS： Of the 36 NSCLC cases, 12 showed partial remission, with an effective rate of 33.3%. The responsive rate for the 32 assessable cases stood at 37.5%. 13 were stable condition, 8 were progressive, and 3 were not given assessment. The toxicity was characterized by bone marrow depression, much as in granulopenia, with rate of Ⅲ＋Ⅳ stood at 13.2%. TWBC lowered to a minimum of 2.4×10^9/L on day 10 to 14 after chemotherapy. The other adverse reactions of chemotherapy included weakness, vomiting and lack of appetite. CONCLUSION： Domestic promethazine is an effective drug for advanced non - small - cell lung cancer （NSCLC） yet with little toxicity and low price, thus serving as a choice for elderly patients with NSCLC.