以卡铂为主的两药联合化疗方案治疗高龄晚期非小细胞肺癌临床研究

Clinical study of Combined chemotherapy containing carboplatin in the treatment of aged patients with advanced non-small cell lung cancer(NSCLC)

目的:评价以卡铂为主的两药联合化疗方案治疗高龄晚期非小细胞肺癌的临床疗效和不良反应。方法:以卡铂为主的三代两药联合方案治疗58例高龄(≥70岁)Ⅲb,Ⅳ期的初治非小细胞肺癌患者。结果:51例患者可评价疗效。近期疗效RR37.2%,SD43.2%,DCR(CR+PR+SD)80.4%,PD19.6%。PFS5个月,OS9个月。分层分析显示PS评分<2分组在DCR、PFS、OS显著优于PS评分=2分组。<75岁组与≥75岁组,不同性别,Ⅲb、Ⅳ期,有无合并内科疾患之间无差异。Ⅲ-Ⅳ级粒细胞减少、肌肉关节痛、乏力不适的发生率分别为37.9%、10.3%、13.8%,Ⅲ-Ⅳ度不良反应发生率PS评分=2分组在血液学毒性、肌肉关节痛、乏力不适等方面显著高于PS评分<2分组。结论:以卡铂为主的两药联合化疗方案治疗高龄晚期非小细胞肺癌有效率高,不良反应可以耐受,尤其对PS评分<2分者。

Objective：To evaluate the therapeutic and adverse effect of combined chemotherapy containing carboplatin in aged patients with NSCLC.Methods：Combined chemotherapy containing carboplatin was used in 58 aged（70） NSCLC patients with clinical staging of IIIb and IV.Results：Therapeutic effect can be evaluated in 51 cases,with RR 37.2%,SD 43.2%,DCR（CR ＋ PR ＋ SD） 80.4%,and PD 19.6%.No significance could be observed between groups of different age,genders,clinical staging,with or without complication.PFS was 5 months and OS was 9 months.Degree Ⅲ-Ⅳ bone marrow depression（BMD） 37.9%,muscle and joint pain 10.3%,and fatigue 13.8%.The incidence of adverse effect in group of PS 2 was obviously higher than that of PS = 2.Conclusion：Combined chemotherapy containing carboplatin used in aged NSCLC patients exhibits a high response rate,acceptable adverse effect,especially in the group with PS 2.