吉西他滨单药或联合卡铂治疗老年晚期非小细胞肺癌疗效观察

Gemcitabine alone versus gemcitabine plus carboplatin in treatment of elderly patients with advanced non-small cell lung cancer

目的评价吉西他滨单药或与卡铂联合对老年晚期非小细胞肺癌(NSCLC)化疗的安全性和可行性。方法 48例年龄≥65岁的晚期NSCLC患者随机分为单药治疗组和联合用药组。单药治疗组:盐酸吉西他滨1000 mg/m^2,静脉滴注,第1、8天,21 d为一疗程。联合用药组:吉西他滨1000 mg/m^2,静脉滴注,第1、8天;卡铂,第1天,以AUC=5计算所得的剂量静脉滴注。21 d为一疗程。结果单药治疗组有效率为20.8%;联合用药组有效率33.3%,两组有效率差异有统计学意义(P<0.05)。单药治疗组中位生存期8.2个月,1年生存率32.1%。联合用药组中位生存期9.6个月,1年生存率为39.4%;两组1年生存率比较,差异无统计学意义(P>0.05)。联合用药组3～4级白细胞和血小板减少发生率均显著增高(P<0.05),但粒细胞减少性发热、感染及出血的发生率并没有显著增加。结论吉西他滨单药或吉西他滨联合卡铂均是治疗老年晚期NSCLC的较好方案,不良反应均可耐受。

Objective To compare the efficacy and toxicity of gemcitabine and gemcitabine plus carboplation in treatment of elderly patients with locally advanced or metastatic non - small - cell lung cancer （NSCLC）. Methods 48 eligible patients above 65 years old who had previously been left untreated and were in stage ⅢB or IV NSCI,C were randomly assigned to receive either gemcitabine alone （1000 mg/m^2 on days land 8 ） or gemeitabine plus earboplatin （area under the curve 5 on day 1 ） every 21 days. Results The overall response rate was 20. 8% in gemeitabine group and 23.3% in gemcitabine with carboplatin group, respectively （P 〈0. 05）. The median overall survival time was 8.2 months in gemcitabine group and 9. 6 months in gemeitabine with earboplatin group （ P 〉 0. 05 ）. The 1 - year overall survival rate was 32. 1% in gemcitabine group and 39.4% in gemcitabine with carboplatin group, respectively（ P 〉 0. 05 ）. The frequency of grades 3 to 4 leucopenia and thrombocytopenia was significantly higher in the gemcitabine with carboplatin group （ P for both variables 〈 0. 05 ） but without associated increase in fever, infection or bleeding. Conclusion In advanced NSCLC, the single gemcitabine or gemeitabine plus earboplatin is tolerable and effective for elderly patients with advanced stages m B and IV NSCLC.