多西他赛单药与联合奈达铂在老年晚期非小细胞肺癌一线治疗中的疗效比较

A comparison study on docetaxel alone and combined with nedaplatin as first-line treatment in elderly patients with advanced non-small cel lung cancer

目的探讨多西他赛单药与联合奈达铂在晚期老年非小细胞肺癌（NSCLC）一线治疗中的疗效比较，并评价毒副反应。方法收集116例≥70岁的老年晚期初治或术后复发、转移的复治NSCLC患者，给予单药多西他赛或多西他赛联合奈达铂的一线化疗，比较两组的客观有效率及中位疾病进展时间、中位生存时间，并评价两组的毒副反应。结果单药组与联合组总有效率分别为29.82％、33.90％，疾病控制率分别为71.93％、79.66％，两组间的差异无统计学意义（P〉0．05）；两组中位疾病进展时间及中位生存时间分别为3/8、4.2和71、7．9个月，两组间的差异无统计学意义（P〉0．05）。亚组分析体力状态（PS）评分0-1分患者中，单药组与联合组中位疾病进展时间分别为4．1、5．0个月，两者的差异有统计学意义（P=0.002），而中位生存期分别为78、8．4个月，差异无统计学意义（P〉0．05）。两组患者毒副反应耐受，IgE良好，联合组血液学毒性、消化道反应发生率高于单药组（P〈0．05）。结论多西他赛单药与联合奈达铂一线治疗老年晚期NSCLC总体疗效相当，安全性良好。在PS评分0～1分患者中联合治疗可能更具优势。

Objective To compare the efficacy and safety of docetaxel alone and combined with nedaplatin as first-line treatment in elderly patients with advanced non-small cell lung cancer （NSCLC）. Methods A total of 116 patients with advanced NSCLC were treated with docetaxel alone （monotherapy group） or docetaxel combined with nedaplatin （combination therapy group）. Results The overall response rate, disease control rate, median time to progression and overall survival time in monotherapy group were 29.82%, 71.93%, 3.8 months and 7.1 months respectively and those in combination therapy group were 33.90%, 79.66%, 4.2 months and 7.9 months, respectively; there were no significant differences between the two groups（P〉0.05）. But in the subgroup with PS 0- 1 the median time to progression in monotherapy group was shorter than that in combination group （4.1months vs 5.0 months, P=0.002）. Conclusion The efficacy and side effects in two groups were similar; however docetaxel combined with nedaplatin may be a better choice for NSCLC patients with PS 0 - 1.