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目的评价单用多西他赛(Docetaxel,DOC)和DOC联合卡培他滨化疗方案治疗老年晚期非小细胞肺癌(Non-small cell lung cancer,NSCLC)的临床效果。方法选择本院收治的82例老年晚期NSCLC患者,随机分为A、B两组,每组各41例,其中A组予以单用DOC化疗方案:在第1、8天予以静脉滴注多西他赛35mg/m2,B组患者予以DOC联合卡培他滨化疗方案:在第1、8天予以静脉滴注多西他赛30mg/m2,在第5～18天予以口服卡培他滨625mg/m2。两组患者均在化疗前1d至化疗第2天予以口服地塞米松8mg,每3周后重复一次,用药时间为1～6个周期。全部患者均在治疗结束后每2～3个月复查一次,对两组患者的化疗周期、生存时间、治疗效果及不良反应进行观察比较。结果 A组平均每个患者的化疗周期为(3.7±1.2)个,B组平均每个患者的化疗周期为(3.6±1.1)个,两组患者在接受的化疗周期上差异无统计学意义(t=0.2168,P>0.05)。全部患者中位随访时间为11个月。A组的中位生存时间为3个月,B组的中位生存时间为8个月,两组差异具有统计学意义(χ2=4.55,P<0.05)。A组患者的有效率(response rate,RR)为12.2%,疾病控制率(disease control rate,DCR)为80.5%。B组患者的RR为14.6%,DCR为80.5%。两组RR及DCR差异无统计学意义(RR:χ2=2.48,DCR:χ2=0,P均>0.05)。不良反应中,A、B两组患者中除手足综合征差异具有统计学意义外(χ2=18.36,P<0.01),余不良反应差异均无统计学意义(P均>0.05)。结论采用DOC联合卡培他滨化疗方案治疗老年晚期NSCLC患者能获得较好的RR和DCR,患者较好耐受。与单用DOC化疗方案比较,能够获得较长的中位生存时间,且不良反应中,手足综合征的发生率较低。
Objective To evaluate the clinical effect of single-dose chemotherapy with docetaxel (DOC) and DOC combined with capecitabine in the treatment of advanced non-small cell lung cancer (NSCLC). Methods A total of 82 elderly patients with advanced NSCLC admitted to our hospital were randomly divided into two groups (A and B), 41 patients in each group. The patients in group A received single-agent chemotherapy (DOC): intravenous infusion of docetaxel His race 35mg / m2, B group were given DOC combined with capecitabine chemotherapy: docetaxel 30mg / m2 intravenous infusion on the first and eighth days, on the 5th to 18th days of oral capecitabine 625mg / m2. Two groups of patients were given oral dexamethasone 8mg 1 day before chemotherapy to 2 days after chemotherapy, repeated every 3 weeks, the treatment time was 1 to 6 cycles. All patients were reviewed every 2 to 3 months after the treatment, and the chemotherapy cycle, survival time, treatment effect and adverse reactions of the two groups were observed and compared. Results The average chemotherapy cycle of each patient in group A was (3.7 ± 1.2) and that of group B was (3.6 ± 1.1) cycles per group. There was no significant difference between the two groups in the cycles of chemotherapy t = 0.2168, P> 0.05). All patients were followed up for a median of 11 months. The median survival time in group A was 3 months, and the median survival time in group B was 8 months. The difference between the two groups was statistically significant (χ2 = 4.55, P <0.05). Patients in group A had a response rate (RR) of 12.2% and a disease control rate (DCR) of 80.5%. In group B, RR was 14.6% and DCR was 80.5%. There were no significant differences in RR and DCR between the two groups (RR: χ2 = 2.48, DCR: χ2 = 0, P> 0.05). Adverse reactions, A, B two groups of patients except for hand-foot syndrome difference was statistically significant (χ2 = 18.36, P <0.01), the remaining adverse reactions were no significant difference (P all> 0.05). Conclusion DOC combined with capecitabine chemotherapy for elderly patients with advanced stage NSCLC can get better RR and DCR, the patient is well tolerated. Compared with single chemotherapy with DOC alone, a longer median survival time can be obtained, and the incidence of hand-foot syndrome is lower in adverse reactions.