紫杉醇联合顺铂每周方案治疗老年晚期非小细胞肺癌临床观察

Weekly Paclitaxel and Cisplatin in the Treatment of Elderly Advanced Non-small Cell Lung Cancer

背景与目的肺癌是最常见的恶性肿瘤之一,随着人口老龄化,老年晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的比例逐渐增大,如何给予这些病人最佳的治疗是目前研究的热点。本研究的目的在于观察紫杉醇联合顺铂每周方案一线治疗年龄≥70岁晚期NSCLC患者的疗效和毒副反应。方法年龄≥70岁初治的晚期NSCLC患者(ⅢB和IV期)50例,接受紫杉醇联合顺铂每周方案化疗:紫杉醇(PTX)80mg/m2加入5%葡萄糖溶液250mL中静脉滴注1h,第1,8天,用紫杉醇前常规给予抗过敏预处理;顺铂(DDP)20mg/m2加入3%氯化钠溶液250mL中静脉滴注,第1,8天,21天为1周期。结果共入组50例患者,在可评价疗效的48例患者中,CR1例,PR18例,SD26例,PD3例,有效率为39.6%,中位生存期为14.8(95%CI:3.2-32.2)个月,1年生存率58.3%,中位疾病进展时间4.5(1.7-7.8)月。主要不良反应是白细胞下降(60%)、贫血(62%)、恶心呕吐(30%)、脱发(100%),未出现与化疗相关的死亡。结论年龄≥70岁老年晚期非小细胞肺癌(NSCLC)患者可以耐受紫杉醇联合顺铂每周方案化疗,并可以从中获益。

Background and objective Lung cancer is one of the most common cancers in the world. The number of elderly lung cancer patients is expected to rapidly increase. Therefore, the management of elderly fung cancer patients is becoming a major challenge in the field of oncology. This study was to evaluate the efficacy and safety of weekly paclitaxel （PTX） and cisplatin （DDP） as the first-line chemotherapy on advanced NSCLC patients of more than 70 years old. Methods Fifty chemotherapy-naive patients with advanced NSCLC more than 70 years old were administrated weekly paclitaxe] and pisplatin regiment： PTX 80 mg/m2 intravenous infusion for i h, dl, d8 （given routine premedications before PTX）, DDP 20 mg/m2intravenous infusion, dl, d8, every 21 days. Results Total 50 patients were enrolled, and 48 patients were evaluable for response. The ORR （overall response rate） was 39.6%; median survival time （MST） was 14.8 months; One year survival rate was $8.3%. Most common adverse events were leucopenia （60%）, anemia （62%）, nausea and vomiting （30%）, alopecia （100%）. There were no chemotherapy-related deaths. Conclusion The patients of advanced NSCLC more than 70 years old can tolerate weekly paclitaxel and cisplatin and can get benefit from this regiment.