摘要
目的探讨并存疾病及年龄对晚期非小细胞肺癌一线单药化疗耐受性的影响。方法回顾性分析61例本院肿瘤内科收治的70岁及以上一线行单药化疗的晚期非小细胞肺癌患者临床资料。患者的中位年龄为72岁，状态评分（PS）0--1分52例，2分9例。一线化疗方案为吉西他滨或者多西他赛，平均化疗周期数为3．4次。采用Charlson并存疾病指数（CCI）评价并存疾病。Charlson并存疾病指数为0分者纳入无并存疾病组，≥1分者纳入有并存疾病组。采用NCI—CTC3．0版标准评估不良反应。结果年龄及PS不能预测3或4级化疗不良反应。有并存疾病组的35例患者行单药化疗后3或4级血液学毒性的发生率显著高于无并存疾病组的26例患者（40．0％比15．4％，x2=4．36，P=0．037）。此外，有并存疾病组粒细胞缺乏发热、3或4级非血液学毒性及因不良事件中断治疗的发生率也高于无并存疾病组。最常见的并存疾病为糖尿病及慢性肺病。有慢性肺病的患者3或4级非血液学毒性的发生率升高（44．4％比11．5％，x2=6．061，P=0．032）。结论年龄和Ps不能预测单药化疗的耐受性，而有并存疾病的老年患者单药化疗后不良反应，尤其是3或4级血液学毒性的发生率显著增高。疗前并存疾病的评价有助于判断老年肺癌患者单药化疗的耐受性。
Objective To evaluate the impact of comorbidity and age on the tolerance of first line single-agent chemotherapy in elderly patients with advanced non-smalL cell lung cancer（NSCLC）. Methods Clinical data of 61 elderly patients with advanced NSCLC（aged over 70 years, median age 72 years） receiving first-line single-agent chemotherapy were retrospectively analyzed in this study. Performance status（PS） between 0-1 score was in 52 patients, PS 2 score in the other 9 patents. Patients were treated with gemcitabine or docitaxel as the first-line chemotherapy, and the median number of chemotherapy cycles was 3.4. Comorbidity was assessed by Charlson comorbidity index （CCI）. Patients with CCI equal to 0 were classified as non-comorbidity group（n= 26）, and patients with CCI^I were classified as comorbidity group（n= 35）. Adverse reactions were graded by using the criteria of NCI-CTC v3.0. Results Age and PS could not predict adverse effects of grade 3 or 4. The incidence of hematologic toxicity of grade 3 or 4 was higher in comorbidity group than in non- comorbidity group（40.0vs. 15.4%, Z2 --4.36,P=0. 037）. The incidences of febrile neutropenia, non hematologic toxicity of grade 3 or 4 and treatment suspension were higher in comorbidity group than in non comorbidity group. The most common types of comorbidity were diabetes and chronic pulmonary disease. The incidence of non-hematologic toxicity of grade 3 or 4 was increased in patients with chronic pulmonary disease as compared with patients without chronic pulmonary disease（44.4G vs. ll. 5%,Z2=6.061,P--0.032）. Conclusions The incidences of adverse reactions, especially hematologic toxicity of grade 3 or 4 are significantly increased in patients with comorbidity after single- agent chemotherapy. Evaluation of comorbidity before treatment is helpful to predict the tolerance of single aent chemotherapy in elderly NSCLC patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第11期1148-1151,共4页
Chinese Journal of Geriatrics
关键词
癌
非小细胞肺
抗肿瘤联合化疗方案
Cancer,non-small cell lung
Antineoplastic combind chemotherapy protocols
