多西他赛对老年非小细胞肺癌患者心脏毒性的临床研究

Clinical Study Cardiac Toxicity of Docetaxel for Elderly Patients with Non-small Cell Lung Cancer

目的:研究分析多西他赛对老年非小细胞肺癌患者心脏毒性。方法:本文研究患者选自本院2014年9月-2015年9月收治的60例老年非小细胞肺癌患者,应用多西他赛30.0~37.5 mg/m2,静脉滴注,第1、8天给药,每21天为1周期,共用药3个周期。并给予预处理及止吐等治疗,观察治疗效果及于化疗前、化疗结束时、结束后12、24、48、72 h监测患者心脏毒性。结果:60例患者中,完全缓解为11例,部分缓解为24例,稳定14例,临床控制率为81.67%。化疗前24 h、化疗结束时、化疗结束12、24、48、72 h点血清c Tn I与C反应蛋白均高于治疗前,治疗前后比较差异均有统计学意义(P<0.05)。9例患者出现心电图改变,占15.00%,其中窦性心动过缓2例(3.33%),窦性心动过速4例(6.67%),房室传导阻滞2例(3.33%),ST-T改变1例(1.67%)。7例为Ⅰ级毒性反应,2例为Ⅱ级毒性反应。结论:多西他赛对老年非小细胞肺癌患者虽然有较好的治疗效果,但化疗后可导致患者出现心脏毒性,在临床用药中应对药物的毒性作用加强监测及处理,确保患者安全。

Objective： To s^udy the analysis of cardiac toxicity in elderly patients with non-small cell lung cancer for Docetaxel.Method： 60 cases of elderly patients with non-small cell lung cancer from September 2014 to September 2015 were selected for this study, they were given Docetaxel 30.0-37.5 mg/m2, intravenous infusion in the first and eighth day, administered every 21 days for 1 cycle, they were treated 3 cycles.Then, they were given the pretreatment and antiemetic therapy.The therapeutic effects of chemotherapy and chemotherapy before were observed, the patients with cardiac toxicity monitoring at the end, after the end of 12, 24, 48 and 72 h were compared.Result： In 60 cases, 11 cases of complete remission, partial remission in 24 cases, 14 cases were stable, clinical control the rate for 81.67%. The levels of serum cTnI and C in the serum of before chemotherapy, after chemotherapy, after chemotherapy 12, 24, 48 and 72h were higher than those before treatment, the difference was statistically significant （ P〈0.05 ） .There were 9 patients with ECG changes, accounting for 15%, including sinus bradycardia 2 cases （ 3.33% ） sinus, sinus tachycardia in 4 cases （ 6.67% ）, 2 cases （ 3.33% ） of atrioventricular block, ST-T changes in 1 case （ 1.67% ） .72 cases of grade [ toxicity, 2 cases of grade II toxicity.Conclusion： The combination of Docetaxel for elderly patients with non-small cell lung cancer patients, although there is a better therapeutic effect, but after chemotherapy can cause cardiac toxicity in patients, in clinical drug toxicity should to drugs and strengthen the monitoring and treatment, ensure the safety of the patients.