摘要目的 比较GP方案与吉西他滨(GEM)单药治疗老年人晚期非小细胞肺癌(NSCLC)的近期疗效、生存状况及不良反应.方法 85例老年Ⅲ～Ⅳ期NSCLC患者按照起始治疗方案的不同分为GP组(43例)及GEM组(42例).GP组接受GEM 1.0 g/m2第1、8天+顺铂( DDP) 75 mg/m2第2天至第4天治疗,GEM组接受GEM 1.25 g/m2第1、8天化疗.两组均治疗3周为1个周期,至少2个周期后按实体瘤疗效评价标准( RECIST)评价近期疗效及生存状况,评价不良反应.结果 GP组和GEM组治疗有效率分别为48.84％(21/43)和35.71％(15/42),差异无统计学意义(x2=1.708,P=0.424).GP组1年生存率39.53％(17/43),2年生存率9.30％(4/43),中位生存时间(MST)为11个月；GEM组1年生存率26.19％(11/42),2年生存率7.14％(3/42),MST为9个月,两组中位生存时间比较差异无统计学意义(t=1.377,P=0.172).GP组恶心、呕吐发生率(34.88％)较GEM组(7.14％)高,差异有统计学意义(x2=9.796,P=0.002),其他不良反应两组接近,患者可耐受.结论 对于老年晚期NSCLC患者,GP方案和GEM单药化疗疗效相当,不良反应接近,GEM单药的胃肠道反应更轻.

abstractsObjective To evaluate and compare the efficacy and toxicity of gemcitabin(GEM) plus cisplantin and GEM on the chemotherapy of elderly patients advanced non-small-cell lung cancer (NSCLC).Methods 85 elderly patients with stage 3 to 4 NSCLC were randomized into gemcitabine plus cisplatin (group GP) and GEM (group GEM).In group GP,patients received GEM on day 1 and day 8 at dose 1.0 g/m2,add cisplatin on day 2 to day 4 at dose 75 mg/m2. In group GEM, patients would received single GEM at dose 1.25 g/m2.The the therapy circle was 3 weeks and undertaken least 2 circles before the treatment efficacy and survival would be evaluated according RECIST. Results In GP group the response rate was 48.84 ％(21/43),In GEM group the response rate was 35.71％(15/42),the difference of response rate between two groups was not statistically significant(x2=1.708,P=0.424).The median survival were 11 months to Gp group and 9 months to GEM group. The 1 year survival rates of GP group were 39.53 ％ and of GEM group were 26.19 ％. The survival time between two groups was not statistically significant(t=1.377,P=0.172).The same toxicity in both groups was defected, Nausea and vomiting occurred were more serious in GP group than that in GEM group (x2=9.796, P=0.002). Conclusion GP and GEM are both effective for treatment of elderly advanced NSCLC.There are no significantly differences on efficacy and toxicity in 2 groups. Side effects on alimentary system are obviously less in GEM group than that in GP group.