吉西他滨联合卡铂治疗老年非小细胞肺癌的临床观察

Gemcitabine and carboplatin in the treatment of elderly patients with advanced non-small cell lung cancer

目的:观察吉西他滨联合卡铂在晚期老年非小细胞肺癌(NSCLC)中的疗效和毒性。方法:2003年5月～2006年4月共40例患者入组,中位年龄74岁(65～84岁)。治疗方案:吉西他滨1100mg/m2,d1、d8,卡铂(AUC=4),d1,3周重复。观察治疗效果和不良反应以及不同分期及体力状态对生存期的影响。结果:40例患者共完成化疗128个周期。采用意向性分析(ITT),获PR16例,SD15例,PD15例。中位生存时间和1年生存率分别为9.2个月和37.5%。疾病分期和体力状态可能是独立的预后指标。主要毒副反应为骨髓抑制,包括白细胞降低、血小板降低和贫血。无治疗相关死亡。结论:该剂量吉西他滨联合卡铂的治疗方案在老年人NSCLC中疗效较好,毒副反应可耐受,值得临床进一步推广。

Objective：Fifty percent of lung cancers arise in patients over 65 years old and 30% in those over 70. The aim of this study was to evaluate the efficacy and safety of the combination earboplatin-gemeitabine in elderly patients with advanced non-small cell lung cancer （NSCLC）. Methods ： From May 2003 to April 2006, 40 patients were included. Median age was 74 （ range 65-84）. Treatment consisted of gemcitabine 1 100mg/m^2 on days 1 and 8, and carboplatin（ AUC =4） on day 1 , every 21 days. Different cancer staging and performance status（PS） for survival were analysed. Results：A total of 128 cycles were administered for 40 patients.According to the intent-to-treat analysis, 16 patients achieved objective response, 15 stable disease, and 9 progression. Median survival time was 9.2 months and l-year survival rate was 37.5%. Disease stage and PS showed probably independent prognostic value. WHO grades 3-4 toxicities were ： neutropenia, thrombocytopenia and anemia. WHO grades 3-4 toxieities were ： neutropenia, thrombocytopenia and anemia. There was no treatment-related death. Conclusion ： The combination carbnplatin-gemcitabine at these doses is feasible in elderly patients with advanced NSCLC. Tolerability and toxicity are acceptable.