【作者】 王志东； 刘斌； 邱振华； 刘红兵；

【Author】 WANG Zhi-dong,Liu Bin,Qiu Zhen-hua, Liu Hong-bing Department of Medical Oncology,Hunan Province Geriatric Hospital,Changsha 410016, RR.China; Department of Medical Oncology,Second Xiangya Hospital of Central South University,Changsha 410011,P.R.China; Department of Medical Oncology,Xiangtan Hospital of Nanhua University,Xiangtan 411101,P.R.China

【机构】 湖南省马王堆医院肿瘤内科； 中南大学湘雅医学院附属二医院肿瘤科； 南华大学附属湘潭医院肿瘤内科；

【摘要】 目的:评价多西他赛每周用药时辰化疗治疗老年晚期非小细胞肺癌的疗效和安全性。方法:多西他赛 35mg／m2静脉滴注,第1、8、15d,每次凌晨4时开始。每28d重复,每位患者至少接受2疗程化疗。结果:53 例NSCLC完全缓解1例,部分缓解16例,稳定25例,进展11例,有效率32．1％(17／53),临床控制率 79．2％(42／53)。化疗后Karnofsky评分显著提高(P=0．032)。生活质量改善率41．5%,功能状态改善率67．9 ％,临床症状改善率81．1％。全组无疾病进展时间4．1月(95%CI,2．9-6．9),中位生存时间7．8月,一年生存率38．3％(18／47)。骨髓抑制是主要毒性,第1个疗程后粒细胞降低发生率37．2％(20／54),但在第2个疗程加用G-CSF后降至12．1％(11／91),3或4度粒细胞减少分别发生在9．3％(5／54)和2．2％(2／91)的病人中。腹泻和神经病变通常是轻度的,经对症处理可缓解。结论:多西他赛每周用药时辰化疗治疗老年晚期非小细胞肺癌疗效确切,可以改善生活质量,不良反应可以耐受,安全性高,可在临床上推广。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of weekly docetaxel in the chrono-chemotherapy of elderly patients advanced non-small cell lung cancer.Methods Fifty-three elderly patients with advanced non-small cell lung cancer received docetaxel 36mg/m2 IV weekly on days 1,8,15 , at 4AM every time .The schedule was repeated every 28 days.Each patient at least had received 2 course of chrono-chemotherapy.Results One patient had complete response and sixteen patients partial complete. Twenty five patients had stable disease and Eleven patients had progressive disease. The overall response rate was 32.1 % .disease control rate was 79.2 %. Time to progress was 4.1 months (95 % CI, 2.9-6.9),the median survival duration was 7.8 months,the 1-year survival was 38.3 % Myelosuppression was the principal toxicity,granulocytopenia occurred in 37.2 % (20/54)of patients after the first course,but decreased to 12.1% (11/91)during the second course after introduction of G-CSF. Grade 3 or 4 granulocytopenia occurred in 9.3 %(5/54) and 2.2 % (2/91)of patients.Diarrhea and neuropathy were generally mild.which were manageable and reversible.Conclusion Chrono-chemotherapy of weekly docetaxel offers a new treatment option providing meaningful tumor control and symptom relief and well-tolerated side effects for elderly patients with advanced non-small cell lung cancer.更多还原