Dose intensity correlate with survival in elderly patients treated with chemotherapy for advanced non-small cell lung cancer
Dose intensity correlate with survival in elderly patients treated with chemotherapy for advanced non-small cell lung cancer
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DOI：
10.1016/j.lungcan.2008.12.019
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发表时间：
2009-10-01
期刊：
影响因子：
5.3
通讯作者：
Foa, P.
中科院分区：
文献类型：
--
作者：
Luciani, A.;Bertuzzi, C.;Foa, P.
简介：在接受化疗治疗晚期非小细胞肺癌（NSCLC）的老年患者中，通常难以提供足够的剂量强度（DI）。因此，我们在该人群中进行了一项研究，以评估输送的DI及其对临床结局的影响。患者和方法：入选标准为：年龄等于或大于70岁;细胞学或组织学诊断为非小细胞肺癌; IIIB或IV期;既往未接受过晚期疾病化疗。分析时考虑了总相对剂量强度（RDI）。RDI小于80%被认为是肿瘤缩小的次优选择。亚组之间的生存比较（大于或小于80%RDI）doneed.Results：107例患者符合分析。平均年龄为74.3岁。92.5%的受试者的PS为0-1。平均合并症数量为1.86。最常用的化疗方案是长春瑞滨单药和吉西他滨单药。总体平均RDI为68%; 36%的患者接受的RDI >原计划的80%。接受RDI大于或小于80%的患者的客观缓解率（RR）分别为55.2%和33.3%（p < 0.01）;这两组之间的总生存率也有显著差异（p < 0.0001）。基线血红蛋白和体重指数（BMI）的变量，显着影响交付RDI.Conclusions：这些数据表明，在老年患者接受化疗晚期NSCLC的一个足够的剂量强度有显着的积极影响的反应率和总生存期。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。
Introduction: In elderly patients treated with chemotherapy for advanced non-small cell lung cancer (NSCLC), frequently an adequate dose intensity (DI) is difficult to be delivered. We therefore performed in this population a study to assess the delivered DI and its impact on clinical outcome. Patients and methods: Inclusion criteria were: age equal or greater than 70 years; cytological or histological diagnosis of NSCLC; stage IIIB or IV; no previous chemotherapy for advanced disease. Total relative dose intensity (RDI) was taken into account for the analysis. An RDI less than 80% was considered as suboptimal for tumor shrinkage. A survival comparison between subgroups (more or less than 80% RDI) was done.Results: 107 patients were eligible for the analysis. Mean age was 74.3 years. PS was 0-1 in 92.5% of subjects. Mean number of comorbidities was 1.86. The most frequently chemotherapy regimens used were single agent vinorelbine and single agent gemcitabine. Overall mean RDI was 68%; 36% of patients received a RDI > 80% of the originally planned one. The objective response rate (RR) was 55.2% and 33.3% respectively for patients receiving more or less than 80% of the RDI (p < 0.01); a significant difference in overall survival between these two groups (p < 0.0001) was also recorded. Baseline hemoglobin and body mass index (BMI) were the variables that significantly influenced the delivered RDI.Conclusions: These data suggest that in elderly patients treated with chemotherapy for advanced NSCLC an adequate dose intensity has a significant positive impact on both response rate and overall survival. (C) 2008 Elsevier Ireland Ltd. All rights reserved.