老年晚期非小细胞肺癌患者二线铂类联合方案和单药方案疗效的对比研究

Efficacy of platinum-based doublet chemotherapy versus single-agent chemotherapy as second-line treatment in elderly patients with advanced non-small cell lung cancer

目的比较以铂类为基础的二联治疗方案和不含铂类的单药治疗方案在治疗老年人晚期二线非小细胞肺癌(NSCLC)中的临床疗效和耐受性。方法对85例经过一线治疗后进展的老年晚期NSCLC患者进行回顾性分析,分为联合治疗组40例和单药治疗组45例,联合治疗组采用铂类为基础的二联方案,单药治疗组采用二线单药方案。结果联合治疗组和单药治疗组患者的客观缓解率分别为27.5%(11/40)和20.0%(9/45),疾病控制率分别为60.0%(24/40)和73.3%(33/45),差异均无统计学意义(X^2=0.662、1.704,P=0.416、0.192);联合治疗组和单药治疗组患者的中位无进展生存期分别为3.8个月和2.8个月,差异有统计学意义(P=0.045)。联合治疗组的Ⅲ~IV血液学毒性显著性高于单药治疗组。结论在老年晚期NSCLC患者的二线化疗中,铂二联治疗方案较不含铂的单药治疗方案有更长的中位无进展生存期,但也存在更多的中重度血液学毒性。

Objective To compare the efficacy and tolerance of platinum-based doublet chemotherapy versus single-agent chemotherapy as second-line treatment in elderly patients with advanced non-small cell lung cancer( NSCLC).Methods A total of 85 elderly patients with advanced NSCLC after first-line treatment were retrospectively analyzed and divided into the combination therapy group(n=40.taking platinum-based doublet chemotherapy)and the single-agent chemotherapy group(n=45 , receiving single-agent second-line chemotherapy).Results There were no significant differences in the objective response rate ( ORR ) and the disease control rate ( DCR ) between the combination therapy group and the single-agent chemotherapy group( 27.5% or 11/40 vs.20.0% or 9/45,60.0% or 24/40vs.73.3% or 33/45,X^2 =0.662 and 1.704,P =0.416 and 0.192).The median progressi on -free survivaK PFS) was 3.8 months for the combination therapy group and 2.8 months for the single-agent chemotherapy group(P=0.045).The rate of grade Ⅲ/IV hematological toxicity was higher in the combination therapy group than in the single-agent chemotherapy group.Conclusions Platinum-based doublet chemotherapy has longer PFS than the single-agent chemotherapy as secondline treatment in elderly patients with advanced non-small cell lung cancer?and more attention should be paid to its high hematological toxicity.