摘要目的 探讨适合于老年晚期非小细胞肺癌(NSCLC)的化疗方案.方法 70岁及以上Ⅲb期和Ⅳ期老年NSCLC患者68例,按随机数字表法分入吉西他滨单药治疗组(单药组)和吉西他滨联合卡铂治疗组(联合组),每组34例.单药组吉西他滨1000 mg/m~2第1、8天静脉滴注,21 d为1个周期;联合组吉西他滨1000 mg/m~2第1、8天静脉滴注,卡铂按曲线下面积=5的剂量水平给药,第2天静脉滴入,21 d为1个周期;均化疗3个周期.结果 单药组完全缓解(CR)1例,部分缓解(PR)12例,有效率为38%;联合组CR 1例,PR 13例,有效率为4l%,组间差异无统计学意义(P ＞0.05).单药组中位生存时间为9.9个月,1、2年生存率分别为31%和12%;联合组中位生存时间为9.8个月,1、2年生存率分别为32%和14%,组间差异均无统计学意义(均P＞0.05).联合组3～4度白细胞减少及3～4度血小板减少发牛率(分别为47%和38%)明显高于单药组(分别为24%和15%,均P＜0.05).肺癌症状量表观察者表评分显示单药组治疗后食欲缺乏、乏力及疼痛评分均较治疗前明显改善(P＜0.05),而联合组无明显改善;治疗后单药组3种症状评分均明显高于联合组(均P＜0.05).结论 吉西他滨单药化疗方案是治疗老年晚期NSCLC疗效及耐受性均较好的方案.

abstractsObjective To explore a chemotherapeutic regimen suitable for non-small cell lung cancer (NSCLC) in elderly patients. Methods A total of 68 elderly patients with NSCLC (stage Ⅲb/Ⅳ )were equally and randomly divided into single-agent and combinded 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. Results 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 thrombecytopenia (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 ) . Conclusion Single-agent gemcitabine regimen is more suitable for advanced NSCLC in elderly patients.