CAJ | 학술논문

目的探讨年龄≥65岁的晚期非小细胞肺癌(NSCLC)患者含铂方案化疗疗效及预后因素.方法回顾性分析70例年龄≥65岁的ⅢA～Ⅳ期NSCLC患者一线含铂方案化疗疗效及不良反应;Kaplan-Meier法分析生存情况,COX回归法进行多因素预后分析.结果全组中位化疗数为3个周期,共有53例患者可评价疗效,总有效率41.5%(22/53),且疗效不受年龄影响(χ2=1.945,P=0.378);中位无进展生存时间6.0个月,中位生存时间12.5个月;化疗相关血液毒性发生率高;多因素分析提示ECOG评分、远处器官转移数目、化疗周期数是影响预后的独立因素.结论老年晚期NSCLC患者一线含铂方案化疗具有较高疗效,但不良反应发生率高,化疗耐受性较差,合理选择患者是关键;ECOG评分差、多发远处器官转移患者难以从化疗中获益;而对于可耐受化疗患者,3～6周期化疗可明显改善预后.
목적 탐토년령≥65세적만기비소세포폐암(NSCLC)환자함박방안화료료효급예후인소.방법 회고성분석70례년령≥65세적ⅢA～Ⅳ기NSCLC환자일선함박방안화료료효급불량반응;Kaplan-Meier법분석생존정황,COX회귀법진행다인소예후분석.결과 전조중위화료수위3개주기,공유53례환자가평개료효,총유효솔41.5%(22/53),차료효불수년령영향(χ2=1.945,P=0.378);중위무진전생존시간6.0개월,중위생존시간12.5개월;화료상관혈액독성발생솔고;다인소분석제시ECOG평분、원처기관전이수목、화료주기수시영향예후적독립인소.결론 노년만기NSCLC환자일선함박방안화료구유교고료효,단불량반응발생솔고,화료내수성교차,합리선택환자시관건;ECOG평분차、다발원처기관전이환자난이종화료중획익;이대우가내수화료환자,3～6주기화료가명현개선예후.
Objective To evaluate the curative effect and toxicities of platinum-based double regimens for patients aged ≥ 65 with advanced non-small-cell lung cancer (NSCLC) and identify the prognosis factors. Methods 70 patients aged ≥65 with staged ⅢA-Ⅳ NSCLC, who received platinum-based double regimens as first line treatment, were emrolled.Response rates and toxicities were evaluated.Progression free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox regression analysis was used to identify the potential prognosis factors.Results The median chemotherapy cycles was 3.The overall response rate was 41.5 % (22/53), and there was no difference between patients aged ＜70 and ≥70 (χ2 =1.945, P =0.378).The median PFS and OS were 6.0 months and 12.5 months.The chemotherapyrelated hematologic toxicities were common.Multivariate analysis revealed that performance status, numbers of metastasis, chemotherapy cycles were significant independent predictive factors for OS. Conclusion In elderly advanced NSCLC, platinum-based doublets show inspiring efficacy, but with more adverse events, and could not be all well tolerated. It should be personalized. Patients with poor performance status and multiple organs metastasis are hard to benefit from combined chemotherapy.Three to six cycles of chemotherapy is the optimal duration for patients who could be well tolerated.