异长春花碱单药化疗高龄晚期非小细胞肺癌

Single-agent vinorelbine in the treatment of elderly patients with advanced non-small-cell lung cancer

目的 :评价高龄NSCLC患者用异长春花碱单药化疗的生存率、生活质量及能否耐受。方法 :治疗高龄晚期非小细胞肺癌 40例。治疗组 2 0例予以持续深静脉输注异长春花碱 (NVB) 2 4小时 7.5mg m2 第 1— 5天 ,同时第一天快速静滴异长春花碱 7.5mg m2 ,三周后重复 ;对照组 2 0例运用中药薏苡仁提取物 2 0 0ml 天静滴 2 0天 1疗程辅以其他支持治疗 ,每 1月为 1疗程。所有病例至少完成两个疗程 ,除非治疗中发现病情进展。结果 :治疗组有效率 35 %(7 2 0 ) ,患者中位生存期 7.2个月 ,一年生存率 2 5 %;对照组有效率 10 %(2 2 0 ) ,患者中位生存期 4.8个月 ,一年生存率 5 %。结论 :对高龄晚期非小细胞癌患者 ,异长春花碱单药治疗较以中药薏苡仁为主的支持治疗有更好的疗效、生活质量 ,更长的生存期 ,且毒副反应轻微 ,可以耐受。

Purpose:This report evaluate whether the single-agent therapy with vinorelbine (V group) may obtain a high response rate, with acceptable toxicity and improvement in survival and quality of life, comparing with the therapy with Kanglaite (a traditional Chinese medicine) (K group) and other supportive care among elderly patients.Methods:Forty patients with advanced NSCLC were included,20 of whom were allocated to receive continual infusional NVB 7.5mg/m 2 /24hr delivered via a central venous line on days 1-5, and NVB 7.5mg /m 2 was given as a 20 min intravenous infusion on days 1 every 3 weeks; 20 of whom were allocated to receive infusional Kanglaite 200 ml on days 1-20 every month. Patients received a minimum of two courses unless progressive disease was detected. Results:V group: CR 0,PR 7,CR+PR 35%(7/20), median survival time was 7.2 months and projected 1-year survival was 25%; K group:CR 0,PR2,CR+PR 10%(2/20),median survival time was 4.8 months and projected 1-year survival was 5%. Conclusions:In elderly patients with NSCLC, single-agent vinorelbine treatment is associated with better effective,better survival and improved quality of life than Kanglaite .Its toxicity is mild and acceptable.