114例老年肺癌患者铂类药物疗效及不良反应分析

Clinical Analysis on Platinum-based Chemotherapy in 114 Elderly Patients with Advanced Lung Cancer

目的研究老年肺癌患者接受以铂类为基础的两药联合化疗的疗效及安全性,为临床合理应用提供参考。方法回顾性分析某大型三甲医院肿瘤科收治的年龄大于60岁的老年肺癌患者114例,收集其临床资料,根据年龄不同分为60~64岁、65~69岁和≥70岁三个亚组,分析不同含铂类两药联合化疗方案的疗效、血液和胃肠道不良反应等发生情况。结果本研究中的四种联合化疗方案对老年肺癌患者均有效(P<0.001),有效率在26.1%~76.7%之间,EC/EP方案疗效显著高于其他联合化疗方案(P<0.05);其他联合化疗方案的疗效无显著性差异(P>0.05)。所有方案的Ⅲ~Ⅳ级骨髓抑制反应发生率均低于20%,Ⅲ~Ⅳ级消化道反应发生率低于7%,严重不良反应在各年龄组均无显著性差异(P>0.05)。结论以铂类为基础联合第3代细胞毒性药物的两药方案一线治疗老年晚期肺癌患者的疗效较好,毒副反应可以耐受。

Objective To evaluate the efficacy and safety of platinum-based chemotherapy in elderly patients with advanced lung can-cer. Methods To analyze clinical data of 114 elderly patients with advanced lung cancer who were divided into 60~64 years group, 65~69 years group and over 70 years group. Short-term curative effects and hematologic toxicity and gastrointestinal adverse reaction of different chemotherapy regimens were compared. The count data was performed by using chi-square test and the SPSS 19.0 software. Results The four combined chemotherapy regimens for advanced lung cancer were all effective with efficacy span being 26.1%~76.7%. EC/EP chemo-therapy showed the highest total effective rate than the other regimens （P〈0.05）. The incidence of Ⅲ~Ⅳ grades of bone marrow suppression was lower than 20%, and that of gastrointestinal side effects was lower than 7% （P〈0.05）. There were no differences in severe toxic reaction of patients in all groups （P〉0.05） Conclusion The platinum-based combined chemotherapy is effective and well tolerated in elderly pa-tients with advanced lung cancer.