吉西他滨联合卡铂作为诱导方案治疗老年不可手术的非小细胞肺癌

背景与目的：肺癌目前为世界范围内的高发病，每年世界范围内新增病例超过50万例，在我国的大中城市，肺癌的发病率已是恶性肿瘤发病率的首位。其中局部晚期的不可切除的非小细胞肺癌（non—small cell lung cancer，NSCLC）约占40％，随着我国老年人口的增加，肺癌在老年人群中的发病率呈增长趋势，往往由于症状隐匿发病时已是晚期且不可手术治疗。本研究目的是为了评价吉西他滨（GEM）联合卡铂（CBP）在老年不可手术的局部晚期非小细胞肺癌（NSCLC）作为诱导方案的疗效和安全性。方法：对于有明确的病理或细胞学诊断，年龄在65—75岁的晚期不可手术的NSCLC患者，应用GEM联合CBP化疗，用药方法为：GEM1000mg／m^2静脉滴入第1、8天，CBPAUC为5，在第1天给药。21d为1个周期，共2—3个周期。并按RECIST标准评价疗效和WHO毒副反应分级标准记录毒副反应，评价治疗后疗效。结果：可评价的42例患者，共完成89个周期化疗，CR0例，PR17例，NC22例，PD3例，总有效率为40．5％。主要毒副作用为骨髓抑制。结论：GEM联合CBP作为老年不可手术的晚期NSCLC诱导治疗是安全有效的，毒性反应可以接受。

Gemcitabine and carboplatin used as induction regimen for elderly patients with locally advanced unresectable non-small cell lung cancer

Background and purpose:Lung cancer is one of most common diseases,The number of new cases of lung cancer are more than 500 000 per year in the world and it has been ranked as number one in terms of incidence of malignant tumors in China.Unfortunately about 40 percent of the patients were diagnosed as locally advanced unresectable non-small cell lung cancer(NSCLC).Elderly patients with NSCLC also showed an increasing trend in the past years.The purpose of this study was to evaluate the efficacy and safety of gemcitabine(GEM) and carboplatin(CBP) used as induction regimen in the treatment of elderly patients with locally advanced unresectable NSCLC.Methods:42 cases of elderly patients have been cytologically and pathologically confirmed with locally advanced unresectable NSCLC,the age of the patients ranged from 65 to 75.The patients were treated with the combined regimen of gemcitabine and cisplatin.GEM 1 000 mg/m2 intravenously injected by drip on the 1st,8th day and the dosage of CBP was AUC 5 that was used on the 1st day,21 days apart to each cycle,most patients received 2-3 cycles.Treatment response was evaluated according to the criteria of RECIST(Response Evaluation Criteria in Solid Tumor),the side effect of the regimen was judged based on WHO criteria.Results:42 patients were evaluable and received a total of 89 cycles chemotherapy.There were no complete regression that could be observed,but 17 cases had partial regression(PR),22 cases with no change(NC) and 3 cases with progression disease(PD).The overall response rate was 40.5%.The main side effects were hematological toxicity.Conclusions:The GC regimen could be used as induction treatment for elderly patients with locally advanced unresectable NSCLC,and the regimen could be well tolerated and is safe in terms of side effects.