紫杉醇治疗晚期非小细胞肺癌体弱患者的临床效果观察

Clinical effect observation of paclitaxel in the treatment of frail patients with advanced non-small cell lung cancer

目的：观察紫杉醇用于晚期非小细胞癌（NSCLC）体弱型患者的临床疗效，评价该药物的应用安全性。方法选择2010年1月～2014年1月在本院接受治疗的110例体弱型NSCLC患者，采用随机数字表法将其分为观察组（60例）和对照组（50例），观察组以紫杉醇注射液进行治疗，对照组以最佳联合支持疗法施治。比较两组患者的有效率、中位与进展时间间隔、中位生存期、1年生存率，记录观察组患者的不良反应。结果观察组有效率为30.00%，显著高于对照组的4.00%，差异有统计学意义（P＜0.05）。观察组患者的中位与进展时间间隔为（6.0±2.1）个月、中位生存期为（9.5±2.3）个月，长于对照组的（3.0±1.2）个月和（5.1±2.4）个月，观察组1年生存率为33.33%，高于对照组的12.00%，差异有统计学意义（P＜0.05）。观察组患者脱发、关节肌肉酸痛、恶心/呕吐、白细胞总数减少、中性粒细胞减少的发生率分别为56.67%、30.00%、21.67%、26.67%、16.67%，发生率较高，但很少出现Ⅳ度损害。结论紫杉醇治疗晚期NSCLC体弱型患者，可以有效控制肿瘤进展速度，提高患者生存率，具有较高的疗效，但是，患者用药容易发生脱发、关节肌肉酸痛等不良反应，应当加以注意。

Objective To observe the effect of paclitaxel in the treatment of frail patients with advanced non-small cell lung cancer （NSCLC）. Methods 110 cases of frail patients with NSCLC treated in our hospital during January 2010 to January 2014 were selected and were randomly divided into observation group （60 cases） and control group （50 cases） according to digital table method.The observation group were treated by injection with paclitarel,the control group were treated by optimal joint support therapy.The efficiency,time intervals of median and progress,median survival period,sur-vival rate in 1 year of two groups were compared,and the adverse reactions in patients of observation group were recorded. Results The efficiency rate of observation group was 30.00%,higher than 4.00% of the control group,the dif-ference was significant （P〈0.05）.In observation group,time intervals of median and progress was （6.0±2.1） months,medi-an survival period was （9.5±2.3） months,longer than （3.0±1.2） months and （5.1±2.4） months of the control group respec-tively;the survival rate in 1 year of observation group was 33.33%,higher than 12.00% of the control group,the differ-ence was significant （P〈0.05）.The incidence rate of hair loss,joint and muscle pain,nausea and vomiting,reduction in white blood cell counts,reduction in neutrophils of the observation group was 56.67%,30.00%,21.67%,26.67%,16.67%respectively,the incidence was higher,but less Ⅳ damage. Conclusion Paclitaxel in the treatment of frail patients with advanced NSCLC can effectively control tumor progression,increase the survival rate of patients,however,patients are prone to hair loss,joint and muscle pain and other side effects,it should be noted.