82例老年晚期非小细胞肺癌患者的生存分析

Survival Analysis of 82 elderly advanced NSCLC patients

目的:比较老年晚期非小细胞肺癌(NSCLC)患者单药化疗和联合化疗的疗效、生存期及对化疗的耐受性,探讨老年晚期NSCLC患者的治疗方法。方法:回顾性分析2001年1月～2008年6月我院内科收治的年龄≥70岁的晚期NSCLC(Ⅲb-Ⅳ期)患者82例,单药化疗组有23例,联合化疗组有59例,比较两组的疗效、生存情况及对化疗的耐受性。结果:联合化疗组与单药化疗组相比有效率明显提高,分别为35.6%和13.0%(P=0.044);但两组疾病控制率(DCR)分别为74.6%和73.9%(P=0.951);中位生存时间(MST)分别为11.60个月和9.43月(P=0.104);1年生存率分别为47.0%和34.0%(P=0.129)。3～4度化疗副反应联合组高于单药组(P<0.05)。全组患者均未观察到化疗相关死亡。结论:对于体能较好的老年晚期NSCLC患者,可推荐单药化疗。含铂双药方案与单药方案相比,虽然有效率明显提高,但在生存期方面并无优势,且联合方案毒性大于单药。

Objective： The aim of this study is to explore the best method for the advanced elderly NSCLC patients by analyzing the efficacy and toxicity of cisplatin combined chemotherapy and single agent chemo therapy. Methods： We retrospectively analyzed 82 elderly patients （age≥70） with advanced non-small-cell lung cancer （stage Ⅲ b or IV） in our hospital from January 2001 to June 2008. The cisplatin combined group were 59 patients, single-agent group were 23 patients, We compared them in the effectiveness and toxicity. Results： The objective response rate （ORR） was 35.6% in cisplatin combined group, which was significantly higher than 13. 0% in single agent group （P = 0. 044）. Disease control rate （DCR） was 74.6% and 73.9% （P =0. 951）, median survival time （MST） was 11.60 months and 9.43 months （P =0.104）, and one year survival rate was 47.0% and 34.0G （P =0. 129）, respectively in cisplatin combined group and single agent group. Grade 344 toxicity was more serious in cisplatin combined group than that in single agent group （P 〈0.05）. No chemotherapy related death had been observed. Conclusion： The single-agent chemotherapy should be recommended for elderly advanced NSCLC patients with good performance status. The combination of cisplatin combined chemotherapy has no advantage over single agent in the treatment of elderly patients with advanced NSCLC, and the combination treatment was more toxic than single-agent chemotherapy.