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目的:比较紫杉醇联合顺铂每周方案(TP-QW)和三周方案(TP-Q3W)一线治疗年龄≥70岁老年晚期非小细胞肺癌(NSCLC)患者的疗效和毒副反应。方法:年龄≥70岁初治晚期NSCLC患者(ⅢB和Ⅳ)60例,随机分为TP-QW组30例和TP-Q3W组30例,分别接受TP-QW方案(紫杉醇80mg/m2,d1,d8;顺铂20mg/m2,d1,d8,21d为1个周期)和TP-Q3W方案(紫杉醇135mg/m2,d1;顺铂18mg/m2,d1～d4,21d为1个周期)化疗。结果:TP-QW组:CR0例,PR12例,SD16例,PD2例,有效率40.0%;TP-Q3W组:CR0例,PR10例,SD17例,PD3例,有效率33.3%。TP-QW组的有效率略高,差异无统计学意义,P=0.280。TP-QW组中位疾病进展时间4.8个月,TP-Q3W组中位TTP为4.5个月,差异无统计学意义,P=0.709。TP-QW组的中位生存期为14.6个月,1年生存率56.7%;TP-Q3W组的中位生存期为12.7个月,1年生存率46.7%,差异无统计学意义,P=0.208。TP-QW组恶心、呕吐、周围神经毒性和乏力的发生率明显低于TP-Q3W组,差异有统计学意义。结论:TP-QW组的临床疗效与TP-Q3W疗法差异无统计学意义,TP-QW方案的毒副反应较轻,明显低于TP-QW,更适用于年迈体弱的患者和门诊化疗。
OBJECTIVE: To compare the efficacy and side effects of paclitaxel plus cisplatin weekly (TP-QW) and three-week (TP-Q3W) first-line treatment of elderly patients with advanced non-small cell lung cancer (NSCLC) Methods: Sixty patients with advanced NSCLC who were ≥70 years old (ⅢB and Ⅳ) were randomly divided into TP-QW group (30 cases) and TP-Q3W group (30 cases), received TP-QW regimen (paclitaxel 80mg / m2, d1, d8 ; Cisplatin 20mg / m2, d1, d8, 21d for a cycle) and TP-Q3W regimen (paclitaxel 135mg / m2, d1; cisplatin 18mg / m2, d1 ~ d4, 21d for a cycle) chemotherapy. Results: In TP-QW group, there were CR0 cases, PR12 cases, SD16 cases and PD2 cases with an effective rate of 40.0%. TP-Q3W group had CR0 cases, PR10 cases, SD17 cases and PD3 cases with an effective rate of 33.3%. TP-QW group slightly higher efficiency, the difference was not statistically significant, P = 0.280. The median time to progression in the TP-QW group was 4.8 months, and the median TTP in the TP-Q3W group was 4.5 months, with no significant difference (P = 0.709). The median survival time in TP-QW group was 14.6 months and the one-year survival rate was 56.7%. The median survival time in TP-Q3W group was 12.7 months and the 1-year survival rate was 46.7%, with no significant difference (P = 0.208. The incidence of nausea, vomiting, peripheral neurotoxicity and fatigue in TP-QW group was significantly lower than that in TP-Q3W group, the difference was statistically significant. Conclusion: The clinical efficacy of TP-QW group was not significantly different from that of TP-Q3W therapy. The toxicity of TP-QW was lower than that of TP-QW, which was more suitable for patients who were weaker and infirm and outpatient chemotherapy.