CAJ | 학술논문

目的：比较吉西他滨单药与联合奥沙利铂治疗老年人晚期非小细胞肺癌（ NSCLC ）的临床效果。方法Ⅲb期和Ⅳ期老年NSCLC患者56例，按数字表法随机分为吉西他滨单药治疗组（单药组）与吉西他滨联合奥沙利铂治疗组（联合组），每组28例。单药组化疗方案为：吉西他滨1000 mg／m2，第1天，21 d为1个周期。联合组化疗方案为：吉西他滨1000 mg／m2，第1、8天；奥沙利铂化疗剂量按曲线下面积＝5的剂量水平给药，第2天静脉滴注，21 d为1个周期。两组方案均化疗3个周期。结果单药组完全缓解（ CR）1例，部分缓解（PR）12例，有效率为46．4％；联合组CR 1例，PR 13例，有效率为50．0％，两组有效率差异无统计学意义（ P＞0．05）。单药组中位生存时间为9．7个月，1、2年生存率分别为31．3％、12．5％；联合组中位生存时间为10．1个月，1、2年生存率分别为33．8％、15．6％，组间差异均无统计学意义（χ2＝1．743、1．529、1．739，均P＞0．05）。联合组3～4度白细胞减少及3～4度血小板减少发生率分别为50．0％、46．4％，明显高于单药组的28．6％和18．0％（χ2＝4．41、4．69，均P＜0．05）。肺癌症状量表观察者表评分显示单药组治疗后食欲缺乏、乏力及疼痛评分均较治疗前明显改善（t＝2．687、2．789、2．603，均P＜0．05），而联合组无明显改善；治疗后单药组有3种症状评分均明显高于联合组（t＝2．986、3．569、2．764，均P＜0．05）。结论治疗老年人晚期NSCLC，吉西他滨单药化疗方案与联合化疗方案疗效相当且耐受性较好。
목적：비교길서타빈단약여연합오사리박치료노년인만기비소세포폐암（ NSCLC ）적림상효과。방법Ⅲb기화Ⅳ기노년NSCLC환자56례，안수자표법수궤분위길서타빈단약치료조（단약조）여길서타빈연합오사리박치료조（연합조），매조28례。단약조화료방안위：길서타빈1000 mg／m2，제1천，21 d위1개주기。연합조화료방안위：길서타빈1000 mg／m2，제1、8천；오사리박화료제량안곡선하면적＝5적제량수평급약，제2천정맥적주，21 d위1개주기。량조방안균화료3개주기。결과단약조완전완해（ CR）1례，부분완해（PR）12례，유효솔위46．4％；연합조CR 1례，PR 13례，유효솔위50．0％，량조유효솔차이무통계학의의（ P＞0．05）。단약조중위생존시간위9．7개월，1、2년생존솔분별위31．3％、12．5％；연합조중위생존시간위10．1개월，1、2년생존솔분별위33．8％、15．6％，조간차이균무통계학의의（χ2＝1．743、1．529、1．739，균P＞0．05）。연합조3～4도백세포감소급3～4도혈소판감소발생솔분별위50．0％、46．4％，명현고우단약조적28．6％화18．0％（χ2＝4．41、4．69，균P＜0．05）。폐암증상량표관찰자표평분현시단약조치료후식욕결핍、핍력급동통평분균교치료전명현개선（t＝2．687、2．789、2．603，균P＜0．05），이연합조무명현개선；치료후단약조유3충증상평분균명현고우연합조（t＝2．986、3．569、2．764，균P＜0．05）。결론치료노년인만기NSCLC，길서타빈단약화료방안여연합화료방안료효상당차내수성교호。
Objective To investigate the effect of two chemotherapeutic regimens suitable for elderly ad -vanced non-small cell lung cancer(NSCLC).Methods A total of 58 elderly advance nonsmall cell lung cancer pa-tients randomized into two group:single-agent group and combined group .Single-agent group received gemcitabine 1 000mg/m2 at Days 1 and 8 for a 21 day cycle.Combined group received gemcitabine 1 000mg/m2 at Days 1 and 8 in combination earboplatin AUC 5 at Day 2 for a 21 day cycle .All patients in the two groups received 3 cycles of chemotherapeutic regimens.Results Of the single-agent group,complete remission (CR) in 1 cases,partial remis-sion (PR) in 12 cases, the effective rate was 46.4%,and of the combined group,CR in 1 cases,PR in 13 cases,the effective rate was 50.0%,there was no statistically significant difference between the two groups (P>0.05).Of the single-agent group,the median survival time was 9.7 months,1-and 2-year survival rates were 31.3%,12.5%,re-spectively,and of the combined group ,the median survival time was 10.1 months,1-and 2-year survival rates were 33.8%,15.6%,respectively,there were no statistically significant difference between the two groups (χ2 =1.743, 1.529,1.739,all P>0.05).The leutropenia and thrombocytopenia incidence of 3 to 4 grade in the combined group was 50.0%,46.4%,respectively,which were significantly higher than 28.6%and 18.0%in the single-agent group (χ2 =4.41,4.69,all P<0.05).Lung Cancer Symptom Scale scores showed:after the treatment,the anorexia,fatigue and pain scores of the single-agent group improved significantly compared with pre-treatment ( t =2.687,2.789, 2.603,all P<0.05),whereas no significant improvement in the combined group;After the treatment,three symptom scores of the single-agent group were significantly higher than those of the combined group (t=2.986,3.569,2.764, all P<0.05).Conclusion Single-agent gemeitabine regimen efficacy is comparable with that of combined regimen for elderly advanced NSCLC with less adverse effects .