一线含铂两药化疗方案治疗117例老年晚期非小细胞肺癌的疗效分析

Efficacy analysis of two drugs consisting platinum combined with first-line chemotherapeutics regimens on 117 elderly patients with advanced non-small cell lung carcinoma

目的观察以铂类药物为基础联合吉西他滨(GEM)、长春瑞滨(NVB)、紫杉醇(TAX)或其他一线化疗药物两药化疗对术后晚期非小细胞肺癌(NSCLC)老年患者的疗效,并分析影响预后的临床病理因素。方法 117例老年(>60岁)晚期NSCLC患者,术后分别给予GP(GEM+铂类)、NP(NVB+铂类)、TP(TAX+铂类)、其他一线化疗药物+铂类共四种化疗方案,对其资料进行回顾性研究,分析性别、手术方式、病理类型、分化程度、临床分期与患者预后的关系。绘制Kaplan-Meier生存曲线,采用log-rank进行假设检验,采用Cox比例风险回归模型筛选独立预后因素。结果 117例患者的1、3、5年生存率分别为47.23%、17.52%、8.05%。GP、TP、NP组和其他化疗药物组的无进展生存期(PFS)分别为6.0、5.2、6.1和5.5个月(P>0.05),中位PFS为5.7个月。单因素和多因素分析均显示肿瘤分化程度和临床分期是独立的预后因素。结论一线含铂两药化疗方案治疗老年晚期NSCLC的疗效与肿瘤分化程度及临床分期有关,但GP、NP、TP及其他一线化疗药物+铂类的疗效无显著差异。

Objective To investigate the therapeutic effects of Gemcitabine（GEM）,Vinorelbine（NVB）,Paclitaxel（TAX） and other first-line chemotherapeutics plus platinum containing drugs on the elderly patients with advanced non-small cell lung cancer（NSCLC） who had undergone surgery,and analyze the clinicopathological factors influencing the prognosis.Methods One hundred and seventeen advanced NSCLC patients aged 60 or over were treated with GP（GEM＋platinum）,or NP（NVB＋platinum）,or TP（TAX＋platinum）,or other first-line chemotherapeutics plus platinum（OCP） after surgery,and their clinical data were then retrospectively studied to look for the relationship of patients’ prognosis to clinicopathological factors（gender,operation methods,pathological types,differentiation,clinical stages）.The survival curve was plotted with Kaplan-Meier method,hypothesis test was performed by log-rank,and the independent prognostic factors were screened with Cox proportional hazards regression model.Results The one-,three-and five-year survival rates of the 117 patients were 47.23%,17.52% and 8.05%,respectively.The progression free survival（PFS） of GP,NP,TP and OCP groups were 6.0,5.2,6.1 and 5.5 months（P＆gt;0.05）,respectively.The median progression free survival was 5.7 months.Univariate and multivariate analysis showed that the differentiated degrees and clinical stages of elderly NSCLC patients were the independent prognostic factors.Conclusions Clinicopathological factors（differentiated degree and clinical stages） are closely related to one-,three-and five-year survival rates of advanced NSCLC in elderly patients who received treatment of first-line chemotherapeutics plus platinum.However,the efficacy of GP,NP,TP or OCP shows no significant difference.