Bilir C, Durak S, Kızılkaya B, Hacıbekiroglu I, Nayır E, Engin H
Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya.
Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize.
Curr Oncol. 2017 Jun;24(3):e199-e204. doi: 10.3747/co.24.3486. Epub 2017 Jun 27.
Metronomic chemotherapy-administration of low-dose chemotherapy-allows for a prolonged treatment duration and minimizes toxicity for unfit patients diagnosed with advanced non-small-cell lung cancer (nsclc).
Oral metronomic vinorelbine at 30 mg thrice weekly was given to 35 chemotherapy-naïve patients who were elderly and vulnerable to toxicity and who had been diagnosed with advanced nsclc.
Median age in this male-predominant cohort (29:6) was 76 years (range: 65-86 years). Histology was squamous cell carcinoma in 21 patients and adenocarcinoma in 14. There were no complete responses and 9 partial responses, for an overall response rate of 26%. Stable disease was seen in 15 patients (43%), and 11 patients (31%) had progressive disease. The 1-year survival rate was 34%, and the 2-year survival rate was 8%. The survival analysis showed a median progression-free survival duration of 4 months (range: 2-15 months) and an overall survival duration of 7 months (range: 3-24 months).
Metronomic vinorelbine had an acceptable efficacy and safety profile in elderly patients with multiple comorbidities who had been diagnosed with advanced nsclc. Metronomic vinorelbine could be a treatment option for elderly patients with poor performance status who are unfit for platinum-based chemotherapy and intravenous single-agent chemotherapy, and who are not candidates for combination modalities.
节拍化疗——给予低剂量化疗——可延长治疗时间，并将毒性降至最低，适用于被诊断为晚期非小细胞肺癌（NSCLC）的身体状况不佳的患者。
对35例初治的老年患者给予口服长春瑞滨，剂量为30mg，每周3次，这些患者易发生毒性反应，且已被诊断为晚期NSCLC。
在这个以男性为主的队列（29:6）中，中位年龄为76岁（范围：65 - 86岁）。组织学类型为鳞状细胞癌21例，腺癌14例。无完全缓解，9例部分缓解，总缓解率为26%。15例患者（43%）病情稳定，11例患者（31%）病情进展。1年生存率为34%，2年生存率为8%。生存分析显示，中位无进展生存期为4个月（范围：2 - 15个月），总生存期为7个月（范围：3 - 24个月）。
节拍长春瑞滨在合并多种疾病的老年晚期NSCLC患者中具有可接受的疗效和安全性。节拍长春瑞滨可以作为身体状况较差、不适合铂类化疗和静脉单药化疗且不适合联合治疗的老年患者的一种治疗选择。
