CAJ | 학술논문

目的观察培美曲塞或吉西他滨联合卡铂一线治疗老年晚期非小细胞肺癌(NSCLC)的疗效和安全性.方法 ≥70岁的Ⅲb期和Ⅳ期老年NSCLC患者70例,按随机数字表法分入培美曲塞联合卡铂(PC)组和吉西他滨联合卡铂(GC)组,每组35例.PC组:培美曲塞500 mg/m2第1天静脉滴注,卡铂按曲线下面积(AUC) =5的剂量水平第1天静脉滴注,21 d为1个周期.GC组:吉西他滨1000 mg/m2第1、8天静脉滴注,卡铂按AUC=5的剂量水平第1天静脉滴注,21 d为1个周期.结果 PC组完全缓解(CR)0例,部分缓解(PR) 10例,有效率为28.6％;GC组CR0例,PR 8例,有效率为22.9％.两组患者有效率的差异无统计学意义(x2=0.299,P=0.584).PC组患者的中位生存时间为11.0个月,1、2年生存率分别为48.6％和11.4％;GC组患者的中位生存时间为10.0个月,1、2年生存率分别为45.7％和11.4％.两组患者生存曲线的差异无统计学意义(x2=0.01,P=0.919).GC组患者Ⅲ～Ⅳ级粒细胞减少、血小板减少、恶心呕吐的发生率均明显高于PC组(均P＜0.05).肺癌症状量表评分显示,PC组和GC组患者在治疗后的评分均较治疗前改善,且两组差异并无统计学意义(P＞0.05).结论培美曲塞联合卡铂或吉西他滨联合卡铂对老年晚期NSCLC的疗效相近,但培美曲塞联合卡铂可能更安全.
목적 관찰배미곡새혹길서타빈연합잡박일선치료노년만기비소세포폐암(NSCLC)적료효화안전성.방법 ≥70세적Ⅲb기화Ⅳ기노년NSCLC환자70례,안수궤수자표법분입배미곡새연합잡박(PC)조화길서타빈연합잡박(GC)조,매조35례.PC조:배미곡새500 mg/m2제1천정맥적주,잡박안곡선하면적(AUC) =5적제량수평제1천정맥적주,21 d위1개주기.GC조:길서타빈1000 mg/m2제1、8천정맥적주,잡박안AUC=5적제량수평제1천정맥적주,21 d위1개주기.결과 PC조완전완해(CR)0례,부분완해(PR) 10례,유효솔위28.6％;GC조CR0례,PR 8례,유효솔위22.9％.량조환자유효솔적차이무통계학의의(x2=0.299,P=0.584).PC조환자적중위생존시간위11.0개월,1、2년생존솔분별위48.6％화11.4％;GC조환자적중위생존시간위10.0개월,1、2년생존솔분별위45.7％화11.4％.량조환자생존곡선적차이무통계학의의(x2=0.01,P=0.919).GC조환자Ⅲ～Ⅳ급립세포감소、혈소판감소、악심구토적발생솔균명현고우PC조(균P＜0.05).폐암증상량표평분현시,PC조화GC조환자재치료후적평분균교치료전개선,차량조차이병무통계학의의(P＞0.05).결론 배미곡새연합잡박혹길서타빈연합잡박대노년만기NSCLC적료효상근,단배미곡새연합잡박가능경안전.
Objective To observe the clinical efficacy and safety of pemetrexed or gemcitabine combined with carboplatin as the first-line therapy in elderly patients with advanced non-small cell lung cancer (NSCLC).Methods Seventy patients aged 70 years or over with stage Ⅲ b-Ⅳ NSCLC were equally and randomly divided into pemetrexed plus cisplatin group (PC) and gemcitabine plus carboplatin group (GC).Patients in the PC group received pemetrexed (PEM) 500 mg/m2 on day 1,and carboplatin (CBP) AUC5 on day 1 for 21-day cycle.Patients in the GC group received gemcitabine 1000 mg/m2 on days 1 and 8,CBP AUC5 on day 1 for a 21-day cycle.Results In the PC and GC groups,CR 0 and 0,PR 10 and 8,response rates 28.6％ and 22.9％ were observed,respectively.There was no statistically significant difference between the two groups (x2 =0.299,P =0.584).The 1-year and 2-year survival rates of the PC and GC groups were 48.6％ vs.45.7％ and 11.4％ vs.11.4％,respectively,with a median survival of l 1.00 and 10.00 months,without a statistically significant difference between the two groups (x2 =0.01,P =0.919).Regarding toxicities,the incidences of neutropenia/thrombocytopenia,nausea and vomiting (grade Ⅲ ～ Ⅳ) in the GC group were significantly higher than those in the PC group (P ＜ 0.05).According to the observer scale of lung cancer symptoms,the post-treatment scores improved in both the two groups,and with no significant difference between them (P ＞ 0.05).Conclusions PC and GC show similar efficacy for elderly NSCLC patients,however,the toxicities in PC patients are lower than those in GC patients.Thus,pemetrexed combined with carboplatin is an effective chemotherapeutic regimen for advanced NSCLC in elderly patients.