Zheng Jihua, Zhang Weimin, Chen Hai, Xu Zhiyong, Zhou Juan, Xie Bo, Li Lixia, Lin Jinrong
Department of Medical Oncology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China.
Zhongguo Fei Ai Za Zhi. 2009 Feb 20;12(2):122-6. doi: 10.3779/j.issn.1009-3419.2009.02.05.
There is still no standard regiment for the treatment of advanced elderly patients with non-small cell lung cancer (NSCLC). The aim of this study is to explore the best method for the advanced elderly NSCLC patients by analyzing the efficacy and toxicity of cisplatin combined chemotherapy, docetaxel chemotherapy and the best support care (BSC).
One hundred and fifty elderly NSCLC patients (>=65 years) with different treatments from March 2003 to March 2007 in our hospital were retrospectively analyzed.
The objective response rate (ORR) was 41.2% in cisplatin combined chemotherapy, which was significantly higher than 20.0% in docetaxel chemotherapy (P <0.05). Median survival time (MST) was 10.7 months, 9.2 months and 6.3 months, and one year survival rate was 39.7%, 36.7% and 17.3%, respectively in cisplatin combined chemotherapy, docetaxel chemotherapy and the best support care. MST was significantly longer (P <0.05) and one year survival rate was significantly higher (P <0.05) in the patients with chemotherapy than that with best support care. There was no significant difference of MST and one year survival between cisplatin combined chemotherapy and docetaxel chemotherapy (P >0.05). Grade 3-4 toxicity was more serious in cisplatin combined group than that in docetaxel group (P <0.05).
Chemotherapy can prolong the survival time in elderly NSCLC patients. Even though the ORR is higher in cisplatin combined chemotherapy than that in docetaxel chemotherapy, there was no significant difference of MST and one year survival between cisplatin combined chemotherapy and docetaxel chemotherapy (P >0.05), which may due to the more serious toxicity. Docetaxel chemotherapy should be one of the standard regiment for the elderly NSCLC patients.
对于老年晚期非小细胞肺癌（NSCLC）患者，目前仍没有标准化的治疗方案。本研究的目的是通过分析顺铂联合化疗、多西他赛化疗及最佳支持治疗（BSC）的疗效和毒性，探索老年晚期NSCLC患者的最佳治疗方法。
回顾性分析2003年3月至2007年3月在我院接受不同治疗的150例老年NSCLC患者（≥65岁）。
顺铂联合化疗的客观缓解率（ORR）为41.2%，显著高于多西他赛化疗的20.0%（P<0.05）。顺铂联合化疗、多西他赛化疗及最佳支持治疗的中位生存时间（MST）分别为10.7个月、9.2个月和6.3个月，1年生存率分别为39.7%、36.7%和17.3%。化疗患者的MST显著更长（P<0.05），1年生存率显著更高（P<0.05）。顺铂联合化疗与多西他赛化疗的MST和1年生存率无显著差异（P>0.05）。顺铂联合组3-4级毒性比多西他赛组更严重（P<0.05）。
化疗可延长老年NSCLC患者的生存时间。尽管顺铂联合化疗的ORR高于多西他赛化疗，但顺铂联合化疗与多西他赛化疗的MST和1年生存率无显著差异（P>0.05），这可能是由于毒性更严重。多西他赛化疗应是老年NSCLC患者标准治疗方案之一。
