【摘要】 目的观察吉西他滨联合卡铂治疗高龄晚期非小细胞肺癌(NSCLC)的疗效及毒副作用。方法30例晚期非小细胞肺癌患者给予吉西他滨与卡铂联合治疗,吉西他滨1000mg/m2,静滴,第1、8天,卡铂AUC5,静滴,第1天。28天为一周期,每例患者治疗2周期以上。两个治疗周期后评价疗效和毒性,并随访评判缓解期及生存期。结果全组完全缓解1例,部分缓解13例,稳定13例,进展3例,总有效率为46.7%。初治组有效率为47.1%,复治组为46.2%。两组有效率无显著性差异(P>0.05)。中位生存期10.6个月(7~23个月),1年生存率46.0%。生存质量(KPS评分)改善19例(63.3%),稳定8例(26.7%),下降3例(10.0%)。最常见的毒副作用为骨髓抑制,Ⅲ~Ⅳ度白细胞和血小板下降发生率分别为30.0%和26.7%,其余毒副作用均轻微,可耐受。结论吉西他滨联合卡铂治疗高龄晚期非小细胞肺癌患者疗效较好,主要毒性为血液学毒性,辅以重组人粒细胞集落刺激因子(rhG-CSF)、重组人白介素-11(rhIL-11)以及免疫和营养支持治疗,可以顺利完成化疗。吉西他滨联合卡铂可作为高龄晚期非小细胞肺癌患者的一线治疗方案。更多还原

【Abstract】 Objective To evaluate the efficacy and toxicity of the combination of gemcitabine and carboplatin in the treatment of patients with advanced non-small cell lung cancer(NSCLC).Methods Thirty patients with locally advanced(stage IIIB)or metastatic(stage IV)NSCLC were enrolled into the study.The patients received gemcitabine 1000mg/m2 on days 1,8 and carboplatin AUC 5 on days 1,with 28 days as a cycle.Each patient received at least two cycles.Results Of the 30 patients,1 case got complete response,13 cases got partial response,13 cases had stable duration,and 3 cases showed progressive,with all overall response rate of 46.7% . The response rate was 47.1% in the initial patients and 46.2% in the retreated patients.The median survival duration was 10.6 months.The 1-year survival rate was 46.0% .There were 19 patients whose KPS score increased.The main toxicities were leukopenia(incidence of 30.0% for grade III+IV)and thrombocytoprnia(incidence of 26.7% for grade III+IV).Conclusion Combination chemotherapy of gemcitabine and carboplatin is effective in the treatment of elderly patients with advanced non-small cell lung cancer。The main adverse effects are severe hematological toxicities. Combination chemotherapy will be completed succeccfully when rhG-CSF、rhIL-11, immunity and nutrition used as a support treatment. Gemcitabine and carboplatin can be used as first-line protocol chemotherapy in elderly patients with advanced non-small cell lung cancer.更多还原