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目的探讨吉西他滨(GEM)联合顺铂(DDP)方案及长春瑞滨(NVB)联合DDP方案在治疗老年晚期非小细胞肺癌的临床效果及毒性反应。方法63例晚期老年非小细胞肺癌患者随机分为两组,吉西他滨组31例,长春瑞滨组32例。分别评价其疗效。结果吉西他滨组完全缓解(CR)2例,部分缓解(PR)11例,有效率为41.94%。长春瑞滨组完全缓解(CR)3例,部分缓解(RP)11例,有效率43.75%。两组间差异无显著性(χ2=0.02,P>0.05)。中位生存期吉西他滨组为9.3个月,长春瑞滨组为9.5个月,中位缓解期吉西他滨组为4.3个月,长春瑞滨组为4.4个月。毒性反应:吉西他滨组白细胞Ⅲ/Ⅳ度下降发生率为12.90%,长春瑞滨组白细胞Ⅲ/Ⅳ度下降发生率为34.38%,长春瑞滨组明显高于吉西他滨组(χ2=4.00,P<0.05);吉西他滨组血小板Ⅲ/Ⅳ度下降4例,发生率为12.90%,明显高于长春瑞滨组(χ2=4.41,P<0.05);长春瑞滨组发生外周静脉炎6例,发生率为18.75%,明显高于吉西他滨组(χ2=5.42,P<0.05)。结论吉西他滨联合顺铂与长春瑞滨联合顺铂治疗老年晚期非小细胞肺癌的近期临床效果相近,中位生存期及中位缓解期相似,一般状况良好(KPS≥70分)的老年患者能够耐受。
Objective To investigate the clinical effects and toxicity of gemcitabine (GEM) combined with cisplatin (DDP) and vinorelbine (NVB) combined with DDP in the treatment of advanced non-small cell lung cancer. Methods Sixty-three elderly patients with advanced non-small cell lung cancer were randomly divided into two groups: 31 in gemcitabine group and 32 in vinorelbine group. Respectively, evaluate its efficacy. Results In gemcitabine group, 2 cases were completely relieved (CR) and 11 cases were partly relieved (PR), the effective rate was 41.94%. Vinorelbine group 3 cases of complete remission (CR), partial response (RP) in 11 cases, the effective rate was 43.75%. No significant difference between the two groups (χ2 = 0.02, P> 0.05). The median survival was 9.3 months in the gemcitabine group, 9.5 months in the vinblastine group, 4.3 months in the gemcitabine group with a median remission, and 4.4 months in the vinblastine group. Toxicity: The incidence of grade Ⅲ / Ⅳ leukopenia in gemcitabine group was 12.90%, that in vinorelbine group was 34.38%, and that in vinorelbine group was significantly higher than that of gemcitabine group (χ2 = 4.00, P <0.05) ). In the gemcitabine group, 4 cases of platelet Ⅲ / Ⅳdecreased, the incidence was 12.90%, which was significantly higher than vinorelbine group (χ2 = 4.41, P <0.05). There were 6 cases of peripheral phlebitis in vinorelbine group 18.75%, significantly higher than gemcitabine group (χ2 = 5.42, P <0.05). Conclusions The short-term clinical effects of gemcitabine combined with cisplatin and vinorelbine plus cisplatin in the treatment of advanced non-small cell lung cancer are similar. The median survival time and median remission period are similar. Elderly patients generally in good condition (KPS≥70) By