摘要
目的观察紫杉醇单药与长春瑞滨联合顺铂一线治疗老年晚期非小细胞肺癌的疗效及毒副反应。资料和方法57例患者，均经病理或细胞学证实的Ⅲ期以上非小细胞肺癌，有可测量病灶，其中男29例，女28例，年龄65～75岁。病理分型为腺癌32例，鳞癌25例，TNM分期Ⅲ34倒，Ⅳ期23例。按所接受的方案分为紫杉醇单药组及顺铂联合长春瑞滨组，其中紫杉醇175mg·m^-2，静脉滴注大于3h；顺铂25mg·m^-2，静脉点滴，第一天至第三天，长春瑞滨25-30mg／m^2．21日为一周期（分别于第1、8日各给药1次）。每例患者治疗2周期以上.疗效及毒副作用评估按照WHO抗肿瘤药物客观疗效标准评价。总缓解（有效）率以CR＋PR计算。统计学处理两组相比，采用χ^2检验。结果紫杉醇单药组：完全缓解0例，部分缓解13例，稳定10例，有效率为43．3％。顺铂联合长春瑞滨组：完全缓解1例，部分缓解11例．稳定6例，有效率为44．4％。最常见的副反应为骨髓抑制、消化道反应、肾功能损害、便秘等，其中长春瑞滨联合顺铂纽便秘、肾毒性、外周静脉炎，Ⅲ～Ⅳ度骨髓抑制、胃肠道反应多于紫杉醇单药组.结论紫杉醇联单药治疗晚期非小细胞肺癌的疗效与长春瑞滨联合顺铂疗效相当，毒副反应轻可以耐受，是老年患者较理想的一线化疗方法。
Objective To explore the effects and toxicities of Paclitaxel alone and Vinorelbine plus Cisplatin in treatment of elderly NSCLC patients. Methods A total of 57 patients with advanced elderly NSCLC patients diagnosed by pathology were randomly divided into two groups. Group A and Group B. In Group A Only Paclitaxel was given. In Group B Vinorelbine plus Cisplatin were given with 21 days as and toxicoty. Results The response a cycle. All patients received at least 2 cycle treatment. To evaluate Response rates （CR ＋ PR） rate of patients were 43.3% in A group and 44.4% in B group. The peripheral phlebitis kidney damage , Grade Ⅲ/Ⅳ rates of nausea/vomiting, myelo-supression in A group were lower than those in B group （ P 〈 0.05） . Conclusion Paclitaxel alone and Vinorelbine plus Cisplatin are both effective for elderly advanced NSCLC. But the toxicities are lower in Paclitaxel alonegroup which is favorable for the elderly.
