吉西他滨联合顺铂一线治疗老年晚期非小细胞肺癌的近期疗效及不良反应

Short-term effects and adverse reactions of gemcitabine combined with cisplatin in treatment of advanced non-small cell lung cancer in elderly patients

目的探讨吉西他滨联合顺铂一线治疗老年晚期非小细胞肺癌的近期疗效及不良反应。方法选择2013年1月至2014年12月就诊的行化疗的老年晚期非小细胞肺癌患者80例,应用数字随机表法随机分为对照组和观察组,每组40例。对照组采用紫杉醇联合顺铂方案化疗,观察组采用吉西他滨联合顺铂化疗,比较2组的近期疗效、不良反应、中远期生存情况、血清肿瘤标志物表达水平、癌因性疼痛及疲乏评分、生存质量评分。结果2组的客观缓解率、总有效率差异无统计学意义(P>0.05)。观察组的恶心呕吐、血小板减少、肝功能损伤、脱发、关节疼痛等发生率均低于对照组(P<0.05)。2组的1年生存率、3年生存率比较,差异均无统计学意义(P>0.05)。治疗后,2组的癌胚抗原(CEA)、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCC)表达水平均较治疗前显著降低(P<0.05),而组间CEA、CA125、SCC表达水平比较,差异均无统计学意义(P>0.05)。治疗后,观察组的癌因性疼痛评分、癌因性疲乏评分均低于对照组(P<0.05),观察组各方面生存质量评分均高于对照组(P<0.05)。结论采用吉西他滨联合顺铂方案对老年晚期非小细胞肺癌患者实施化疗,具有显著的近期疗效和中远期疗效,可有效控制肿瘤进展,减少患者化疗不良反应,减轻其癌因性疲乏及疼痛程度,有利于提高其生存质量水平。

Objective To explore the short-term effects and adverse reactions of gemcitabine combined with cisplatin in treatment of advanced non-small cell lung cancer (NSCLC) in elderly patients. Methods Eighty elderly patients with NSCLC, who were treated in our hospital from January 2013 to December 2014, were randomly divided into observation group ( n =40) and control group ( n =40), according to random number table. The patients in control group were treated by paclitaxel combined with cisplatin, however,the patients in observation group were treated by gemcitabine combined with cisplatin. The short-term effects, adverse reactions, medium and long-term survival status, serum levels of tumor markers, scores of cancer-related pain and fatigue as well as survival quality scores were compared between the two groups. Results There were no significant differences in objective response rate and total effective rate between the two groups ( P >0.05). The incidence rates of nausea and vomiting, thrombocytopenia, liver function injury, alopecia and joint pain of the patients in observation group were significantly lower than those in control group ( P <0.05). And there were no significant differences in 1-year survival rate and 3-year survival rate between the two groups ( P >0.05). After treatment, the expression levels of carcinoembryonic antigen (CEA), carbohydrate antigen (125) CA125 and squamous cell carcinoma antigen (SCCC) in both groups were significantly lower than those before treatment ( P <0.05), but there were no significant differences in the expression levels of CEA CA125 and, SCC between the two groups ( P >0.05). Moreover, the scores of cancer-related pain and fatigue of the patients in observation group were significantly lower than those in control group ( P <0.05). The survival quality scores of patients in observation group were significantly higher than those in control group ( P <0.05). Conclusion Gemcitabine combined with cisplatin is highly effective in treating NSCLC in elderly patients, which can control the progress of tumor, reduce the adverse reactions of chemotherapy, relieve cancer-related pain and fatigue so as to improve the quality of life.