Abstract
背景与目的目前推荐第三代药物单药治疗老年晚期非小细胞肺癌（non-small cell lung cancer, NSCLC），本研究旨在比较紫杉醇脂质体与紫杉醇脂质体联合奥沙利铂一线治疗老年晚期NSCLC的临床疗效及毒副作用。方法2008年7月-2010年8月未经过治疗的经病理学或细胞学确诊的老年晚期NSCLC患者69例随机分成紫杉醇脂质体单药组（35例）和紫杉醇脂质体联合奥沙利铂组（34例），单药组给予紫杉醇脂质体135 mg/m2 d1；联合组给予紫杉醇脂质体135 mg/m2 d1+奥沙利铂125 mg/m2 d1，每21天重复，至少治疗2个周期，评价疗效和不良反应。结果单药组与联合组相比，治疗有效率（22.9% vs 35.3%, P=0.297）、疾病控制率（60.0% vs 70.6%, P=0.450）和1年生存率（28.6% vs 41.2%, P=0.724）差异均无统计学意义，联合组的无疾病进展生存期（progression free survival, PFS）较单药组延长1.5个月（5.0个月 vs 3.5个月，P=0.024）。在毒副作用方面，两组白细胞减少（P=0.808）、血小板减少（P＞0.999）、贫血（P=0.477）、恶心和呕吐的发生率（P=0.777）相当；两组发生神经毒性的患者分别为33例和3例（97.1% vs 8.6%, P＜0.001），但均为Ⅰ度-Ⅱ度。结论紫杉醇脂质体联合奥沙利铂用于一线治疗老年晚期NSCLC疗效略优于紫杉醇脂质体单药，能延长患者的PFS，临床应用安全性好。
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