紫杉醇联合卡铂或顺铂治疗老年晚期非小细胞肺癌的临床对比分析

A Clinical Analysis of Combined Chemotherapy of Paclitaxel plus Carboplatin and Paclitaxel plus Cisplatin for Elderly Advanced Non-Small Cell Lung Cancer

目的比较紫杉醇联合卡铂（TC）方案与紫杉醇联合顺铂（TP）方案治疗老年晚期非小细胞肺癌（NSCLC）的疗效及毒副反应。方法64例老年晚期NSCLC分为两组,其中TC组27例,TP组37例。TC组：紫杉醇85 mg/m^2,d1,8,卡铂300 mg/m^2,d2;TP组：紫杉醇85 mg/m^2,d1,8,顺铂25 mg/m^2,d2-4。结果TC组与TP组的总有效率分别为37.0%和35.1%,差异无统计学意义（P〉0.05）;中位疾病进展时间分别为5.7个月和5.2个月,差异无统计学意义（P〉0.05）;毒副反应：TC组骨髓抑制较TP组明显,差异有统计学意义（P〈0.05）,而TP组胃肠道反应、肾功能损害及中枢神经系统毒性显著高于TC组,差异有统计学意义（P〈0.05）。结论TC方案和TP方案治疗老年晚期NSCLC的疗效相似,但TC方案的毒副反应较轻,该方案是治疗老年晚期NSCLC较理想的方案。

Objective To observe and compare the efficacy and toxicity of combined chemotherapy regimen of paclitaxel plus carboplatin（TC） and paclitaxel plus cisplatin（TP） for elderly advanced non-small cell lung cancer（NSCLC）.Methods 64 elderly patients with advanced NSCLC were divided into TC group of 27 cases（paclitaxel 85 mg/m^2,d1,8,carboplatin 300 mg/m^2,d2） and TP group of 37 cases（paclitaxel 85 mg/m^2,d1,8,ciplatin 25 mg/m^2,d2-4）.Results The overall response rates were 37.0% in the TC group and 35.1% in the TP group.The median time to progression were 5.7 months in the TC group and 5.2 months in the TP group.No significant statistical difference in the overall response rates and the median time to progression were found between the two groups（P〈0.05）.The major toxicity in the TC group was marrow depression.The main toxicities in the TP group were gastrointestinal reaction,renal damage and central nervous system toxicity.Conclusion TC regimen and TP regimen in the treatment of elderly patients with advanced NSCLC have similar efficacy,but the toxicity of TC regimen is lighter,TC regimen is an ideal regimen for elderly patients with advanced non-small cell lung cancer.