多西他赛和吉西他滨协同放疗增敏对老年非小细胞肺癌近期疗效观察

Short-term effectiveness and safety of concurrent docetaxel and gemzar combined with radiotherapy for elderly patients with non-small-cell lung cancer

目的观察三维适形放疗分别联合多西他赛、吉西他滨治疗老年非小细胞肺癌的疗效及不良反应。方法将106例经病理学或细胞学证实的老年非小细胞肺癌患者随机分为多西他赛组和吉西他滨组;所有入组患者均先给予2个周期诱导化疗,多西他赛20～25mg/m2,d1、8、15,28天重复;吉西他滨800mg/m2,d1、8、15,28天重复。有效者于化疗第3个周期的第1天开始联合局部三维适形放疗,共接受4个周期化疗。结果多西他赛组完全缓解率(CR)为27.7%,部分缓解率(PR)为63.0%,总有效率(CR+PR)为90.7%;吉西他滨组CR为15.4%,PR为69.2%,总有效率(CR+PR)为83.7%;两组差异无显著性(χ2=3.48,P=0.154);多西他赛组3～4级血液毒性发生率1.9%,西他滨组为9.6%,两组有显著性差异(P=0.001)。结论多西他赛和吉西他滨联合三维适形放疗同步治疗老年非小细胞肺癌安全、有效;吉西他滨组3～4级血液毒性高于多西他赛组。

Objective To evaluate the therapeutic significance of concurrent doeetaxel and gemzar combined with radiotherapy for elderly patients with non-small cell lung cancer （NSCLC）. Methods Totall 106 pathological or cytologically confirmed elderly patients with NSCLC were randomly divided into docelaxel and gemzar groups. All patients were first given two cycles of induction chemotherapy： docetaxcl 20-25mg/m^2, d1, d8, d15 and d28; gemzar 800mg/m^2, d1 , d8, d15 and d28. Respondcrs underwent radiotherapy on the first day of the third cyele ehemotherapy, and totally four cyeles of chemotherapy were applied. Results Doeetaxel group： CR 27.7% , PH 63.0% , and CR ＋ PR 90. 7% ; gemzar group： CR 15.4% , PR 69.2% , and CR ＋ PR 83.7%. There was no significant difference between two groups （x^2 = 3.48, P = 0. 154）. The incidence of Ⅲ to Ⅳ hematologic toxicity was 1.9% in docetaxel group and 9. 6% in gemzar group （P =0. 001 ）. Conclusion This trealment is well-tolerated and effective in elderly patienls with NSCLC. The elderly patients in gemzar group may experience more Ⅲ to Ⅳ hematologic tuxicities.