厄洛替尼一线治疗老年非小细胞肺癌合并慢性阻塞性肺疾病临床价值探讨

The clinical value of Erlotinib first-line treatment for elderly patients with non-small cell lung cancer with chronic obstructive pulmonary disease

目的研究厄洛替尼一线治疗老年非小细胞肺癌合并慢性阻塞性肺疾病（COPD）的临床价值。方法选择2012年1月~2013年3月我院接诊的80例老年非小细胞肺癌合并COPD的患者进行研究,随机分为厄洛替尼组和化疗组,对患者分别采用厄洛替尼一线用药和化疗治疗。比较两组治疗的效果和毒副作用,并对两组患者跟踪随访,调查两组患者的生存期。结果厄洛替尼组患者治疗的有效率明显高于化疗组（χ~2=4.2667,P=0.0389）,控制率也明显高于化疗组（χ~2=4.7127,P=0.0299）。厄洛替尼组患者骨髓抑制、胃肠道反应的发生率明显低于化疗组（χ_1~2=20.3135,P=0.0000;χ_2~2=4.0525,P=0.0441）;两组患者的皮疹发生率差异显著（χ~2=13.0909,P=0.0003）。厄洛替尼组患者的无进展生存期（PFS）、总生存期（OS）均明显长于化疗组,差异有统计学意义（t_1=3.2579,P=0.0017;t_2=6.3139,P=0.0000）。结论厄洛替尼一线治疗老年非小细胞肺癌合并COPD效果良好,可显著提高治疗的有效率,降低毒副作用发生率,延长患者的生存期。

Objective To study the clinical value of Erlotinib first-line treatment for elderly patients with non-small cell lung cancer with chronic obstructive pulmonary disease（COPD）.Methods 80 cases of elderly patients with nonsmall cell lung cancer patients with COPD from January 2012 to March 2013 were selected and randomly divided into Erlotinib group and chemotherapy group,patients were treated by Erlotinib first-line treatment and chemotherapy respectively.The efficacy and toxic and side effect of treatment between two groups were compared,and patients were followed up,the lifetime of patients between two groups were searched.Results The effective rate of the Erlotinib group was significantly higher than that of the chemotherapy group（χ~2=4.2667,P=0.0389）,the control rate was also significantly higher than that of the chemotherapy group（χ~2=4.7127,P=0.0299）.The incidence of myelosuppression and gastrointestinal reaction in the Erlotinib group were significantly lower than those in the chemotherapy group（χ_1~2=20.3135,P=0.0000;χ_2~2=4.0525,P =0.0441）;the incidence of rash between two groups was significant difference（χ~2=13.0909,P =0.0003）.Progression-free survival（PFS） and overall survival（OS） in the Erlotinib group were significantly longer than those in the chemotherapy group,the difference was statistically significant（t_1=3.2579,P =0.0017;t_2=6.3139,P =0.0000）.Conclusion Erlotinib first-line treatment for elderly patients with non-small cell lung cancer with COPD has good effect,whih can significantly improve the treatment efficiency,reduce the incidence of toxic and side effect,prolong lifetime of patients.