Lou Guang-yuan, Li Tie, Gu Cui-ping, Hong Dan, Zhang Yi-ping
Chemotherapy Center, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Zhonghua Yi Xue Za Zhi. 2010 Jan 12;90(2):100-2.
To explore a chemotherapeutic regimen suitable for non-small cell lung cancer (NSCLC) in elderly patients.
A total of 68 elderly patients with NSCLC (stage IIIb/IV) were equally and randomly divided into single-agent and combined groups. Patients in single-agent group received gemcitabine 1000 mg/m(2) at Days 1 and 8 for a 21-day cycle. Those in combined group received gemcitabine 1000 mg/m(2) at Days 1 and 8 in combination carboplatin AUC5 at Day 2 for a 21-day cycle. The drugs were intravenously administered. All patients received 3 cycles of treatment.
In single-agent and combined groups, CR 1 and 1, PR 12 and 13, response rates 38% and 41% were respectively observed. There was no statistically significant difference between two groups (P > 0.05). The 1-year and 2-year survival rates of single-agent and combined groups were 31% vs 32% and 12% vs 14% with a median survival of 9.9 and 9.8 months without a statistically significant difference (P > 0.05). The rates of leucopenia and thrombocytopenia (III-IV degree) were 47% and 38% in combined group and they were higher than 24% and 15% in single-agent group with a statistically significant difference (P < 0.05). The observer scale of lung cancer symptom scale showed that the post-treatment scores of appetite, fatigue and pain significantly improved in single-agent group while no improvement was observed in combined group. Also the scores of appetite, fatigue and pain of single-agent group were higher than those of combined group after chemotherapy (P < 0.05).
Single-agent gemcitabine regimen is more suitable for advanced NSCLC in elderly patients.
探索适合老年非小细胞肺癌(NSCLC)患者的化疗方案。
将68例老年NSCLC(Ⅲb/Ⅳ期)患者平均随机分为单药组和联合组。单药组患者在第1天和第8天接受吉西他滨1000mg/m²,每21天为一个周期。联合组患者在第1天和第8天接受吉西他滨1000mg/m²,并在第2天联合卡铂AUC5,每21天为一个周期。药物均通过静脉给药。所有患者均接受3个周期的治疗。
单药组和联合组分别观察到完全缓解(CR)1例和1例,部分缓解(PR)12例和13例,有效率分别为38%和41%。两组之间差异无统计学意义(P>0.05)。单药组和联合组的1年和2年生存率分别为31%对32%和12%对14%,中位生存期分别为9.9个月和9.8个月,差异无统计学意义(P>0.05)。联合组白细胞减少和血小板减少(Ⅲ-Ⅳ度)发生率分别为47%和38%,高于单药组的24%和15%,差异有统计学意义(P<0.05)。肺癌症状量表观察显示,单药组治疗后食欲、乏力和疼痛评分显著改善,而联合组未见改善。且化疗后单药组食欲、乏力和疼痛评分高于联合组(P<0.05)。
单药吉西他滨方案更适合老年晚期NSCLC患者。