CHEMOTHERAPY FOR OLDER PEOPLE WITH NON‐SMALL CELL LUNG CANCER
CHEMOTHERAPY FOR OLDER PEOPLE WITH NON‐SMALL CELL LUNG CANCER
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老年非小细胞肺癌患者的化疗
DOI：
10.1111/jgs.2000.48.11.1536
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发表时间：
2000
影响因子：
6.3
通讯作者：
Hidetada Sasaki
中科院分区：
文献类型：
--
作者：
A. Kanda;M. Yanai;H. Hirai;Tomoko Suzuki;Hidetada Sasaki
编辑：肺癌在老年人中很常见，是癌症相关死亡的主要原因。20世纪80年代以来的随机试验表明，姑息性化疗与缓解症状有关，并对晚期非小细胞肺癌(NSCLC)患者产生微小的生存优势，1/2，但化疗在老年患者中的应用尚未建立。以前的回顾研究表明，年龄对症状缓解或生存没有影响，因此，不应将患有晚期非小细胞肺癌的老年人排除在姑息化疗试验之外。3然而，尚不清楚全身化疗是否对老年人有益。我们研究了化疗对65岁或65岁以上晚期非小细胞肺癌患者住院时间和生存率的影响。自1994年以来，我们前瞻性地调查了东北大学医院老年科和呼吸科转诊的所有连续83名年龄在65岁或以上的晚期非小细胞肺癌患者。排除2例非肺癌死因的患者和7例直到死亡后未被随访的患者，剩下74例患者(平均年龄75岁，SD 5.4)进入本研究。它们的特点如表1所示。我们决定根据国际分期系统进行非小细胞肺癌分期。4符合条件的患者获得书面知情同意。根据治疗前的调查、知情同意和临床感觉，三位经验丰富的肺部肿瘤学家将这些患者分为两类：全身化疗或最佳支持治疗。29例接受化疗的患者接受MVP(丝裂霉素8 mg/m2、长春新碱6 mg/m2、顺铂80 mg/m2)或DP(多西紫杉醇60 mg/m2、顺铂80 mg/m2)治疗，每3周1次。胸科放射科-
To the Editor: Lung cancer is common among older people and is the major cause of cancer-related death. Randomized trials from the 1980s showed that palliative chemotherapy was associated with symptom relief and produced a small survival advantage for patients with advanced non-small cell lung cancer (NSCLC), 1•2 but the application of chemotherapy to older patients has not been established. Previous retrospective studies suggested that age had no influence on symptom relief or survival, and, therefore, older people with advanced NSCLC should not be excluded from palliative chemotherapy trials.3 However, it is unknown whether systemic chemotherapy is beneficial for older people. We studied the effects of chemotherapy on hospitalization and survival in patients aged 65 years or older with advanced NSCLC. Since 1994, we have prospectively investigated all 83 consecutive patients aged 65 years or older with a diagnosis of advanced NSCLC referred to the Geriatric and Respiratory Department of Tohoku University Hospital. Two patients whose causes of death were not lung cancer and seven who were not followed until death were excluded, leaving 74 patients (mean age 75, SD 5.4) who were examined in this study. Their characteristics are displayed in Table 1. We decided to stage NSCLC based on the international staging system.4 Written informed consent was obtained from eligible patients. Three well experienced pulmonary oncologists divided these patients into two treatment categories: systemic chemotherapy or best supportive care only, according to the pretreatment investigation, informed consent, and clinical sense. Twenty-nine patients receiving chemotherapy were treated with either MVP (mitomycin 8 mg/m2, vindesine 6 mg/m2, and cisplatin 80 mg/m2 ) or DP (docetaxel 60 mg/m2 and cisplatin 80 mg/m2 ) every 3 weeks. Thoracic radiother-