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单药化疗与靶向治疗对80岁以上老年晚期非小细胞肺癌患者的疗效和安全性对比研究

Comparative study of the efficacy and safety between mono-chemotherapy and targeted therapy for patients over 80 years old with advanced non-small cell lung cancer

摘要:

目的 对比分析单药化疗与靶向治疗作为一线方案治疗≥80岁老年晚期非小细胞肺癌(NSCLC)患者的疗效与安全性.方法 根据治疗方案将本院肿瘤科收治的108例≥80岁的晚期NSCLC患者分为两组,A组为单药化疗组(n=60),B组为靶向治疗组(n=48).主要终点为中位总生存期(0S)和中位无进展生存期(PFS),次要终点为客观缓解率(RR)、疾病控制率(DCR)和安全性.结果 B组中位PFS和中位OS均明显长于A组(P=0.013,0.025).B组的1年生存率明显高于A组(P =0.001),而两组2年总生存率差异无统计学意义(P=0.605).两组RR差异无统计学意义(P =0.408);B组DCR明显高于A组(P =0.043).B组患者皮疹发生率明显高于A组(P=0.036),A组消化道不良反应和血液学毒性发生率明显高于B组.结论 与单药化疗相比,靶向治疗≥80岁老年晚期NSCLC患者有更长的PFS和OS获益,且不良反应轻微,患者耐受性良好.

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Objective To compare the efficacy and safety between mono-chemotherapy and targeted therapy as first-line regimen for patients over 80 years old with advanced non-small cell lung cancer (NSCLC).Methods 108 NSCLC patients aged ≥80 years in our hospital were divided into two groups according to the therapeutic program,of which group A was mono-chemotherapy group (n =60) and group B was targeted therapy group (n =48).The primary endpoint was overall survival (OS) and progression free survival (PFS),while secondary endpoint was objective response rate (RR),disease control rate (DCR) and safety.Results The median PFS,and median OS in group B were significantly longer than those in group A (P =0.013,0.025).The 1-year survival rate of group B was significantly higher than that of group A (P =0.001),and there was no significant difference between the two groups (P =0.605).There was also no statistically significant difference in RR between the two groups (P =O.408).DCR in Group B was significantly higher than that in group A (P =0.043).The incidence of skin rash in group B was significantly higher than that in group A,and the incidence of adverse reactions and hematological toxicity in group A was significantly higher than that in group B.Conclusions Compared with single-agent chemotherapy,epithelial growth factor receptor-tyrosinekinase (EGFR-TKI) targeted therapy has longer PFS and OS benefits for patients ≥ 80 years with advanced NSCLC,and was well tolerated by patients.

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