The pooled analysis of single gemcitabine for non-small cell lung cancer patients with elderly age

Objective:Gemcitabine,used as single agent for elderly patients with non-small cell lung cancer (NSCLC),was demonstrated effective in this population based on phase II studies.The aim of this study was to summarize all those phase II studies with the hope to get a comprehensive understanding of gemcitabine efficacy.Methods:The PubMed database was used to search all the papers on NSCLC associated with gemcitabine used as single agent in the first line setting till to March 31st,2010.And the medians and their 95% CI of overall response rate (ORR),disease control rate (DCR),progression free survival (PFS),and overall survival (OS) were calculated.Results:1.There were 7 papers including 410 patients with performance status (PS) ≤ 2 and advanced stage collected.2.The dose-intensities of gemcitabine were 843.75 mg/m 2 /week-1125 mg/m 2 /week in the 4-week schedule,and 666.7 mg/m 2 /week in the 3-week schedule.3.The median age was 73.8 (95% CI was 72.44,75.16) years old;36.1% (95% CI:31.4%,40.7%) of patients with stage IIIB and 60.5% (95% CI:55.8%,65.2%) of patients with stage IV;35.9% (95% CI:31.2%,40.5%) patients were adenocarcinomas and 43.7% (95% CI:38.9%,48.5%) patients were squamous cell carcinomas (SCCs).4.The ORR,DCR,PFS/TTP,and OS were 22.3% (95% CI:18.2%,26.5%),58.4% (95% CI:53.5%,63.4%),3.6 (95% CI:2.9,5.15) months and 6.68 (95% CI:5.4,8.11) months,respectively.Conclusion:Gemcitabine as single agent applied in this special population was effective and can be well tolerated under different doses and usage.

Gemcitabine plus carboplatin used as induction regimen for elderly patients with locally advanced unresectable non-small cell lung cancer

Objective:The purpose of this study was to evaluate the efficacy and safety of gemcitabine(GEM) and carboplatin(CBP) used as induction regimen in the treatment of elderly patients with locally advanced unresectable non-small cell lung cancer(NSCLC).Methods:Seventy-eight cases of elderly patients have been cytologically and pathologically confirmed with locally advanced unresectable NSCLC,the age of the patients ranged from 65 to 75 years.The patients were treated with the combined regimen of gemcitabine and cisplatin.GEM 1000 mg/m2 intravenously injected by drip on the 1st,8th day and the dosage of CBP was AUC 4 that was used on the 1st day,21 days apart to each cycle,most patients received 2 cycles.Treatment response was evaluated according to the criteria of RECIST(Response Evaluation Criteria in Solid Tumor),the side effect of the regimen was judged based on WHO criteria.Results:Seventy-eight patients were evaluated and received a total of 156 cycles chemotherapy.There were no complete regression that could be observed,but 32 cases had partial regression(PR),37 cases with no change(NC) and 9 cases with progression disease(PD).The overall response rate was 41.0%.The main side effects were hematological toxicity.Conclusion:The GC regimen could be used as induction treatment for elderly patients with locally advanced unresectable NSCLC,and the regimen could be well tolerated and is safe in terms of side effects.

Effects of weekly dose docetaxel monotherapy schedule for elderly patients with non-small cell lung cancer

Objective： To investigate the clinical efficacy and toxicity of weekly dose docetaxel monotherapy schedule in elderly with advanced non-small cell lung cancer （NSCLC）. Methods： 28 patients aged over 65 with advanced NSCLC were received with docetaxel （Aisu） 35 mg/m^2 on days 1, 8 and 15 every 28 days. A clinical evaluation on effectiveness, quality of life and toxicities was performed. Results： 28 patients were given 86 cycles＇ chemotherapy altogether. The overall response rate was 35.7% （10/28）. The clinical beneficial rate was 64.3% （18/28）. Mean KPS was increased from 75.5 at baseline to 87.7 after chemotherapy （P 〈 0.01）; lung cancer symptom scale （LCSS） scores of cough, hemoptysis, chest pain and dyspnea were increased from 64, 65, 62 and 65 to 90, 92, 87 and 88, respectively （P 〈 0.01）. The median time to progression （TTP） was 5.3 months; median survival time （MST） was 8.5 months. The main toxicities were fatigue, leukopenia and decrease of hemoglobin with well tolerance. Conclusion： Weekly dose docetaxel monotherapy schedule is a feasible, well-tolerated, and active scheme in the treatment of the elderly patients with advanced NSCLC.

Influence of comorbidity on the choice of treatment and survival of elderly patients with advanced non-small cell lung cancer

Objective： To identify the influence of comorbidity on the choice of treatment and survival of elderly patients （≥70 years） with advanced non-small cell lung cancer （NSCLC）. Methods： The clinical characteristics and the choices of treatment of 177 elderly patients, who had a good performance status （PS≤1） were retrospectively analyzed in Oncology Department, Shanghai Pulmonary Hospital, between January 2005 to December 2005. Survival data were only analyzed in those whose had received chemotherapy. All patients were stratified by number of comorbidity as none （0）, mild （1-2） and severe （≥ 3） groups. Results： The proportion of patients, who received chemotherapy, with none, mild and severe comorbidity was significantly different （79.3%, 76.2% and 57.4%, P=0.038）, and there was also significantly different about palliative radiotherapy rate among the three groups （21.7%, 11.7% and 37.0%, P=0.014）. The median survival and 1-year survival rate in none, mild and severe comorbidity groups, were 13.6 vs. 10.2 vs. 7.6 months and 53.5% vs. 41.3% vs. 20.8% respectively （Log-rank, P=0.071）. In univariate and multivariate Cox models analysis, only severe comorbidity was a independent hazard factor of survival of elderly patients with NSCLC. Relative ratio （RR, 95% CI）： （2.09, 1.06-4.15）, P=0.034. Conclusion： Comorbidity may affect the choice of treatment of elderly patients with advanced NSCLC slightly, but only severe comorbidity is a independent prognostic factor of survival.

Clinical observation of docetaxel in treating advanced non-small cell lung cancer in the elderly patients

Objective:The aim of our study was to evaluate the clinical efficacy and side effects of docetaxel as single chemotherapy for elderly patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-two elderly patients with advanced NSCLC who were chemotherapy-naive were enrolled in this study. Docetaxel at the doses of 70 mg/m2 was administrated intravenously every 21 days as a cycle, each patient received 2-4 cycles. All patients were followed up until disease progressed or patients died. Results: Among 42 patients, 40 could be evaluated, 1 complete response (CR), 9 partial response (PR), 13 stable disease (SD), 17 progress disease (PD). The overall response rate (CR+PR) was 35% and disease control rate (CR+PR+SD) was 57.5%. The median time to progress (TTP) was 4.2 months, median survival time was 6.1 months and 1-year survival rate was 35.8%. The main toxicity was myelosuppression and decreasing platelet. Conclusion: Single agent docetaxel for elderly patients with advanced NSCLC is an efficient and well-tolerated chemotherapeutic approach with a low toxicity level.

Treatment of etoposide capsule combined with cisplatin or carboplatin in elderly patients with small cell lung cancer

We aimed to explore the efficacy and safety of etoposide capsule combined with cisplatin or carboplatin in the treatment of elderly patients with small cell lung cancer （SCLC）. Methods： From October 2011 to November 2013, 32 elderly patients （71-79 years old） with histopathologically confirmed SCLC in General Hospital of Shenyang Military Region （China） were enrolled in the research. The patients were administrated with lastet capsule 150-175 mg, dl-5, combined with cisplatin 20 mg/m^2 dl-3 or carbopiatin AUC = 5, applied over 2 days. Twenty-one days were 1 treatment cycle. Results：After treatments, 2 cases acquired complete response （CR）, 19 cases acquired partial response （PR）, 8 cases acquired stable disease （SD）, and 3 cases had progression of disease （PD）. The objective response rate was 65.6% （21/32）, disease control rate was 90.6% （29/32）. The median time of progression-free survival （PFS） was 6.9 months, the median survival time was 14.0 months, and 1 year survival rate was 62.4%. The main adverse reactions of 1/11 leukopenia and gastrointestinal reaction were observed. Conclusion： Etoposide capsule combined with cisplatin or carboplatin therapy have curative effect and good tolerance in elderly patients with SCLC.

The related effects of astragalus polysaccharides on the improvement of bone marrow suppression and hematopoietic stem cells during chemotherapy in elderly patients with lung cancer

Objective:To investigate the effects of astragalus polysaccharides(APS)on bone marrow suppression and hematopoietic stem cells during chemotherapy in elderly patients with lung cancer.Methods:120 elderly patients with lung cancer treated in the first hospital of Xingtai city from January 2019 to early December 2019 were divided into the treatment group and the control group by the random number table method,all of whom received pemetrexed+carboplatin chemotherapy,and the treatment group was treated with APS at the same time.The efficacy was evaluated after 2 cycles of chemotherapy,bone marrow suppression was observed,and levels of TCM symptoms score,peripheral blood T lymphocyte subgroup index,L-selectin(CD62L)and macrophage differentiation antigen-1(Mac-1)were measured before and after 2 cycles of chemotherapy.Results:The response rate(RR)was 56.67%in the treatment group and 45.00%in the control group,with no statistically significant difference(P>0.05);The disease control rate(DCR)in the treatment group was 81.67%,which was significantly higher than 65.00%in the control group(P<0.05);The reduction degree of leukopenia in the treatment group was significantly lower than that in the control group(P<0.05);The treatment group had a platelet reduction of grade 1+2 at a rate of 40.00%,and hemoglobin reduction of grade 1+2 at a rate of 28.33%,which were significantly lower than the control group at 65.00%and 58.33%(P<0.05);Compared with those before chemotherapy,the total score of TCM symptoms,serum CD62L and Mac-1 levels in the two groups all decreased significantly after chemotherapy,and they were significantly lower in the treatment group than in the control group(P<0.05);After chemotherapy,CD3+,CD4+and CD4+/CD8+in the treatment group increased significantly and they were all higher in the treatment group than in the control group,while CD8+decreased significantly and was lower in the treatment group than in the control group(P<0.05).There was no statistically significant difference in T lymphocyte subsets before and after chemotherapy in the control group(P>0.05).Conclusion:Astragalus polysaccharide can improve the chemotherapy effect and improve the bone marrow suppression in elderly patients with lung cancer,which may be related to its obvious enhancement of immune function and decrease of CD62L and Mac-1 levels.

^(18)F-FETNIM PET/CT hypoxia imaging in non-small cell lung cancer:preliminary clinical observation

Objective:The aims of this study were to evaluate potential side effects of 18F-fluoroerythronitroimidazole (18F-FETNIM) as a new-type hypoxia-imaging agent and to investigate the feasibility of 18F-FETNIM PET imaging in advanced non-small cell lung cancer (NSCLC) patients and the correlations of hypoxia extent with tumor volume or pathological type. Methods: Twenty-six NSCLC patients were prospectively included in the study. PET/CT scans were performed 2 h after intravenous injection of 18F-FETNIM in all 26 patients. A pixel-by-pixel calculation of tumor to blood (T/B) activity ratio for all image planes was calculated. The number of pixels in the tumor volume with a T/B ratio≥ 1.5,indicating significant hypoxia,was determined and converted to mL units to measure the hypoxia volume (HV). Results: The images were clearly identified after 2 h post-injection of 18F-FETNIM. The tumors in 4 cases were not distinguished from background,while the remaining 22 displayed local 18F-FETNIM uptake in thoracic lesions moderately to markedly higher than background. There was no correlation between 18F-FETNIM uptake with pathological type. There were significant correlations of HV and also the T/B ratio with tumor volume. Conclusion:18F-FETNIM is a promising hypoxia-imaging agent which clinical use is safe and satisfactory. The preliminary study provides valuable methods and experience to its further research.

Efficacy and feasibility of gemcitabine and carboplatin as first-line chemotherapy in elderly patients with advanced non-small cell lung cancer

Background Although platinum-based chemotherapy is a standard first-line treatment in advanced non-small cell lung cancer （NSCLC）, further research for the safety and efficacy of combination chemotherapy in elderly patients has been required. The purpose of this study was to evaluate the efficacy and safety of gemcitabine and carboplatin as first-line treatment in elderly patients with advanced NSCLC and to evaluate the prognostic factors. Methods Eligibility included： （1） age of 70 years or more, （2） histologically confirmed NSCLC, （3） chemotherapy-na＇l＇ve, （4） advanced disease with stage IIIB or IV, （5） Eastern Cooperative Oncology Group （ECOG） performance status （PS） 0-2, （6） adequate organ function. Patients received intravenous carboplatin （area under curve （AUC）=5） on day 1 and gemcitabine （1000 mg/m2） on days 1 and 8, every 3 weeks. Results The medical records of forty patients were reviewed retrospectively. Median age was 73.9 years （range, 70- 84.6）, and there were 27 men （67.5%）. Thirty-seven patients （92.5%） had ECOG PS 0-1. Adenocarcinoma was found in 57.5%. Median cycles were administrated with 4.5 per person （range： 1-6）. Best responses were partial response in 22 （55.0%） patients and stable disease （SD）in 13 （32.5%）. The median progression free survival （PFS） and overall survival （OS） were 5.9 months （95% CI： 4.5-7.3 months） and 9.6 months （95% CI： 8.2-11.0 months）, respectively. Grade 4 hematologic toxicities for neutropenia （7.5%）, thrombocytopenia （7.5%） and anemia （5.0%） were observed. Histology was significant prognostic factor for PFS （P=0.024）. Conclusion Gemcitabine and carboplatin combination chemotherapy is an effective and manageable treatment option in elderly advanced NSCLC patients with good performance status.

卡瑞利珠单抗联合化疗治疗老年非小细胞肺癌的疗效及其对肿瘤标志物的影响

目的观察卡瑞利珠单抗联合化疗治疗老年非小细胞肺癌(NSCLC)患者的疗效及其对肿瘤标志物的影响。方法回顾性选取2019年9月—2021年8月徐州医科大学附属宿迁医院收治的51例老年NSCLC患者作为研究对象,根据治疗方法分为化疗组(n=25)和联合组(n=26)。化疗组患者予以PC方案治疗,联合组患者在化疗组基础上予以注射用卡瑞利珠单抗治疗。2组均以21 d为1个化疗周期,持续治疗3个周期。比较2组近期疗效,治疗前及治疗3个周期后血管内皮因子、肿瘤标志物水平及不良反应发生率。结果联合组疾病控制率为76.92%,高于化疗组的48.00%(χ^(2)=4.561,P=0.033)。治疗3个周期后,2组碱性成纤维细胞生长因子、血管生成素2、血管内皮生长因子、基质金属蛋白酶-9及血清糖类抗原125、糖类抗原19-9、细胞角蛋白19片段抗原21-1、癌胚抗原水平均低于治疗前,且联合组低于化疗组(P<0.05或P<0.01)。联合组反应性毛细血管增生症及免疫相关性疾病的发生率高于化疗组(P<0.01)。结论与单一化疗相比,卡瑞利珠单抗联合化疗治疗老年NSCLC患者虽会增加免疫相关不良反应以及反应性毛细血管增生症的发生率,但后者可更好地改善患者血管内皮功能,降低肿瘤标志物水平,从而提高临床疗效。

吉非替尼单药治疗晚期非小细胞肺癌老年患者的临床分析

目的观察吉非替尼单药治疗对晚期非小细胞肺癌(NSCLC)老年患者的效果和安全性。方法采用吉非替尼(250 mg/d)对87例65岁以上的ⅢB～Ⅳ期NSCLC患者进行治疗,直至病变进展或出现不可耐受的不良反应。结果治疗总有效率为31.0%(27/87);疾病控制率为77.0%(67/87);中位无疾病进展生存时间(PFS)为6.6个月,中位总生存时间为12.3个月;1年生存率为52.9%。腺癌和既往未接受化疗患者的治疗有效率和疾病控制率显著高于非腺癌和既往接受化疗的患者(P<0.05);女性和非吸烟患者的疾病控制率显著高于男性和吸烟患者(P≤0.01)。体能状态ECOG评分0～1、腺癌、非吸烟和吉非替尼治疗有效患者的中位PFS明显优于ECOG评分≥2、非腺癌、吸烟和吉非替尼治疗无效患者(P<0.01);ECOG评分0～1和吉非替尼治疗有效的患者的中位生存时间明显优于ECOG评分≥2和吉非替尼治疗无效患者(P≤0.001)。吉非替尼单药治疗最常见的不良反应为皮疹(56.3%)和腹泻(36.8%)。结论对于晚期NSCLC的老年患者,吉非替尼单药治疗有效且安全,其不良反应均可耐受。

参芪扶正注射液辅助NP方案治疗老年晚期非小细胞肺癌的观察及护理

背景与目的非小细胞肺癌(NSCLC)约占肺癌的80%,其中70%～80%为晚期肺癌,化疗为其主要治疗手段。本研究拟观察参芪扶正注射液辅助NP方案治疗老年晚期NSCLC的疗效及护理。方法将患者随机分组,其中治疗组35例,对照组34例。两组均接受NP方案治疗,长春瑞滨(NVB)25mg/m2静脉滴注,第1、8天,顺铂(PDD)30mg静脉滴注,第1～4天。治疗组化疗期间常规静脉滴注参芪扶正注射液250mL,每日1次,连用10天。结果两组近期疗效差异无显著性(P>0.05)。治疗组血液毒性反应和恶心、呕吐发生率明显低于对照组,差异有显著性(P<0.05)。所有不良反应均能耐受。结论参芪扶正注射液辅助NP方案治疗老年晚期NSCLC安全有效,参芪扶正注射液对老年晚期NSCLC化疗有一定减毒作用。

老年人与中青年晚期非小细胞肺癌化疗后的生存分析比较

目的：比较老年人和中青年人晚期非小细胞肺癌的化疗及生存情况。方法：回顾性分析2001年～2003年我院肿瘤中心收治的Ⅲ～Ⅳ期非小细胞肺癌患者162例，其中年龄大于65岁的老年组有97例，年龄小于或等于65岁的中青年组有65例，比较两组的疗效及生存率。结果：老年组和中青年组接受化疗周期的中位数分别为3次和4次。没有患者达到完全缓解，治疗有效率两组分别为28．9％和32．3％（P〉0．05），Ⅲ度和Ⅳ度骨髓抑制的发生率两组分别为12．4％和7．7％（P〉0．05）。中位生存时间（MST）两组分别为13个月和11个月（P〉0．05）。Cox回归分析发现肿瘤分期和行为状态评分为影响预后的因素。结论：老年非小细胞肺癌患者接受化疗的安全性和疗效与年轻人相比无明显差异。

两种术式治疗老年Ⅰ期非小细胞肺癌的预后分析

目的:探讨不同手术方式(肺楔形切除和肺叶切除)对70岁以上Ⅰ期非小细胞肺癌患者预后的影响。方法:回顾性分析于2000年1月至2006年1月230例接受手术治疗的70岁以上Ⅰ期非小细胞肺癌患者的临床资料,对其预后和影响预后的临床因素进行分析。结果:单因素分析结果显示,吸烟史、T分期、手术方式、淋巴结清扫是患者预后的影响因素(P<0.05)。多因素分析提示,手术方式、T分期、淋巴结清扫均是影响70岁以上Ⅰ期NSCLC患者预后的独立因素(P<0.05)。肺楔形切除组5年生存率42.2%(35/83),肺叶切除组5年生存率50.3%(74/147),组间差异有统计学意义(P<0.05)。进一步分层分析T1a的Ⅰ期非小细胞肺癌患者,行肺楔形切除和肺叶切除的5年生存率差异无统计学意义(51.9%vs.53.3%,P>0.05)。与肺叶切除组相比,肺楔形切除组手术时间短(P=0.035)、术中失血少(P=0.031)、术后住院时间短(P=0.045)。结论:肺叶切除+系统性淋巴结清扫术仍是70岁以上Ⅰ期非小细胞肺癌患者首选的手术方式;T1a期患者行肺楔形切除可获得与肺叶切除相近的远期收益,同时肺组织损失较小,对肺功能差的高龄T1a期患者推荐行肺楔形切除术。

NP方案化疗治疗老年晚期非小细胞肺癌

[目的]评价NP方案治疗老年非小细胞肺癌疗效、毒性反应及其耐受性。[方法]以国产长春瑞宾（NVB）联合顺铂（DDP）方案治疗老年晚期非小细胞肺癌（NSCLC）23例,NVB 25 mg/m^2静脉滴注,第1、8天;DDP 60mg/m^2,第1-3天静脉滴注,每21-28天重复,每周期观察其不良反应,每两周期评价疗效。[结果]本组共完成化疗67个周期,中位周期数2个（2-6个）,总有效率26%,中位生存期10.3个月,1年生存率34.7%。最常见的毒性反应为白细胞减少,发生率为82.6%。胃肠道反应较轻。未见明显肝肾功能损害。[结论]老年非小细胞肺癌患者对于NP方案耐受良好,毒性反应较轻,近期疗效令人满意。

70岁以上高龄广泛期小细胞肺癌的预后分析

目的：分析高龄广泛期小细胞肺癌的治疗与预后相关因素。方法选取1995年1月至2007年8月67例广泛期小细胞肺癌患者，年龄≥70岁。收集资料包括患者年龄、性别、体重、分期、ECOG评分、并发症、治疗前肝肾功能、血常规、乳酸脱氢酶（lactate dehydrogenase，LDH）水平、手术、放疗、一线化疗疗效、化疗周期、二线化疗的临床病例资料，应用单因素和多因素分析预后相关因素。结果67例患者中未做治疗18例（26.9%），49例（73.1%）进行了一线化疗。联合化疗以CE/EP方案为主，能够完成4周期以上化疗患者占32.6%（16/49），平均化疗周期2.92个。化疗有效率为53.1%（26/49），疾病控制率为72.1%（35/49）。8例患者接受二线治疗，9例接受放疗。患者MST为6.9个月（95%CI 5.667～11.100），1、2年生存率分别是26.0%、4%。单因素分析提示预后与疾病分期、ECOG评分、有无合并基础疾病、有无心血管系统疾病、治疗前LDH水平、有无治疗、手术、放疗、化疗疗效密切相关。全组Cox多因素分析显示生存与化疗周期数、一线化疗疗效有关。结论广泛期高龄小细胞肺癌一线化疗疗效部分缓解、化疗周期4个以上是生存独立预后因素。

培美曲塞二钠治疗老年中晚期非小细胞肺癌的近期疗效分析

目的观察培美曲塞联合顺铂治疗老年中晚期非小细胞肺癌（NSCLC）的临床疗效和毒性反应。方法34例Ⅲ-Ⅳ期NSCLC患者均经病理组织学和（或）细胞学检查确诊。培美曲塞联合顺铂治疗后评价疗效。结果34例患者均可评价,获得完全缓解0CR3例,部分缓解PR12例,有效率为44.1%（15/34）。最主要的毒副反应为白细胞及血小板降低,但均可耐受。结论培美曲塞联合顺铂治疗老年中晚期NSCLC有较好疗效,可明显改善患者生存质量,,毒副反应轻,易于耐受。

老年原发性非小细胞性肺癌临床特征

[目的]明确老年原发性非小细胞性肺癌临床及肿瘤生物学特征,为其早期诊断和治疗提供理论指导。[方法]分析安徽医科大学第一附属医院1996年至1998年3年间经病理或(和)细胞学确诊的原发性非小细胞性肺癌病例,将其中大于70岁(老年组)和小于40岁(青年组)作为研究对象,按照临床症状、组织学类型、临床分期、治疗方式和生存率等跟踪随访3年并将相关资料进行统计分析。[结果]在3年间确诊为原发性非小细胞性肺癌病例中,老年组148例,青年组104例。老年组以男性为主,青年组以女性为主,差异分别具有显著性(P<0.05);老年组鳞癌多见,青年组腺癌多见,差异分别具有显著性(P<0.05);老年组多采用以支持和化疗为主的综合治疗,青年组采用以手术为主的综合治疗方案;老年组3年累计生存率为17.5%,中位生存数为14个月;青年组3年累计生存率是28.6%,其中位生存数为18.2个月,差异具有显著性(P=0.018)。[结论]老年原发性非小细胞性肺癌患者主要是男性和鳞癌;老年组的总的生存率和预后较青年组差。

重组人血管内皮抑制素注射液联合NP方案治疗晚期非小细胞肺癌的疗效观察

目的观察了解重组人血管内皮抑制素注射液（恩度）联合NP方案治疗老年晚期非小细胞肺癌（NSCLC）的临床疗效和毒性反应。方法37例Ⅲ～Ⅳ期NSCLC患者均经病理组织学和（或）细胞学检查确诊。恩度联合顺铂治疗2～4个周期后评价疗效。结果37例患者中CR4例，PR15例，有效率51．4％（19／37）。中位TTP为6．8个月，1年生存率为43．2％。最主要的毒副反应为白细胞及血小板降低，但均可耐受。结论恩度联合NP方案治疗老年晚期NSCLC有较好疗效，可明显改善患者生存质量，毒副反应轻，易于耐受。

洛铂、顺铂分别联合足叶乙甙治疗老年小细胞肺癌对照研究

【目的】评估洛铂(lobaplatin,LBP)联合足叶乙甙(etoposide,VP-16)与顺铂(cisplatin,DDP)联合足叶乙甙治疗老年小细胞肺癌的近期疗效和毒性反应。【方法】56例老年小细胞肺癌(small cell lung cancer,SCLC)患者随机分为洛铂联合足叶乙甙的LE组(28例)和顺铂联合足叶乙甙的EP组(28例)。21 d为1周期,连用2个周期后评价近期疗效。每周评估毒性反应。【结果】LE组和EP组有效率(RR)分别为71%和68%,疾病控制率(DCR)分别为89%和86%,均无显著性差异(P>0.05)。两组骨髓抑制无显著性差异(P>0.05);消化道反应LE组和EP组分别为21%和50%,有显著性差异(P<0.05)。【结论】LE和EP均为治疗老年SCLC的有效方案,疗效相当,LE组消化道反应较EP组轻,故LE组患者耐受性更好,特别适合老年患者和曾接受过DDP联合化疗方案的复治患者。