| Purpose:Non-small-cell lung carcinoma(NSCLC) includes squamous cell carcinoma, adenocarcinoma and large cell carcinoma, has been the main type of all lung cancers. It accounted for nearly 80% to 85%. This study intend to use gemcitabine combined with cisplatin and cinobutacini; gemcitabine combined with cisplatin; gemcitabine combined with cinobutacini; gemcitabine single regimen in treating elderly advanced non-small cell lung cancer(NSCLC), meanwhile, aim at investigating and observing the tolerance of toxicity and side effects.Materials and methods:The prospective trial was performed in nine different hospitals, 48 cases from the First Affiliated Hospital of Liaoning Medical University, 35 cases from Liaoning Cancer Hospital And Institute, 6 cases from the First Affiliated Hospital of Dalian Medical University, 5 cases from Shenyang Fifth People Hospital, 1 case from Panjin Central Hospital(formerly known as the First People’s Hospital of Panjin), 2 cases from the People’s Hospital of Liaoning, 2 cases from the First Clinical College of Traditional Chinese Medicine, 13 cases from Anshan Dawn Hospital, 5 cases from Anshan the Forth Hospital, totally 116 patients confirmed by pathology with non-small cell lung cancer, including adenocarcinoma, squamous carcinoma and large cell carcinoma, gland scale cancer and hybrid; All the patientsconfirmed diagnosis of stage III/IV NSCLC with previously untreated; 76 cases of men and 40 cases of women; age range between 65 to 81(the average age was 68.65); ECOG score was around 0 to 2; expected survival over three month; No major organs function was impaired. Using the random number table, one hundred and sixteen patients was randomly divided into A, B, C, D four groups. Group A, 24 patients were treated with gemcitabine combined with cisplatin and cinobutacini; Group B, 30 patients were treated with gemcitabine combined with cisplatin; Group C, 32 patients were treated with gemcitabine combined with cinobutacini; Group D, 30 patients were treated with gemcitabine single regimen. 21 days as a cycle, each patient should receive 4 cycles according to the plan. By comparing the quality of life(QOL) and toxicity and side effects, such as myelosuppressionand gastrointestinal reaction, evaluate the efficacy of the therapy to elderly advanced non-small cell lung cancer(NSCLC).Results:1. Evaluation of efficiency: The total response rates in four groups from high to low were Group A 50%, treated with gemcitabine combined with cisplatin and cinobutacini;Group B 26.7%, treated with gemcitabine combined with cisplatin; Group C 21.9%, treated with gemcitabine combined with cinobutacini; Group D 16.7%, treated with gemcitabine single regimen. The total stable disease(SD) rates in four groups from high to low were Group A 91.7%, Group B 70%, Group C 68.8%, Group D 50%.Overall, to have a more efficacious treatment result, using cisplatin combined with is better than gemcitabine single regimen; using cinobutacini combined with is better than chemotherapy only. Among these groups, Group A, gemcitabine combined with cisplatin and cinobutacini, is far more efficacious than others(p<0.05).2. Adverse reaction: Group A, gemcitabine combined with cisplatin and cinobutacini, gastrointestinal reaction rate 54.84%; myelosuppression rate 38.71%, 19.35% in stage Ⅲ/Ⅳ;constipation rate 12.90%; alopecia rate 16.13%. Group B,gemcitabine combined with cisplatin, gastrointestinal reaction rate 60%; myelosuppression rate 30%,13.33% in stage Ⅲ/Ⅳ; constipation rate 16.67%; alopecia rate 20%. Group C, gemcitabine combined with cinobutacini,gastrointestinal reaction rate 46.63%; myelosuppression rate 31.25%, 0% in stage Ⅲ/Ⅳ; constipation rate 6.25%; alopecia rate 9.38%. Group D, gemcitabine single regimen,gastrointestinal reaction rate 50%; myelosuppression rate 20%, 3.33% in stage Ⅲ/Ⅳ; constipation rate 10%; alopecia rate 13.33%.The incidence rate of adverse reaction, the gemcitabine group was lower than that of combined with cisplatin group, the cinobutacini group was lower than that of the chemotherapy group, but no apparent different(p>0.05).3.ECOG score:Compare the ECOG score of two chemotherapy groups combined with and without cinobutacini. Before taking chemotherapy treatment, there was no distinctive differences between two groups(p>0.05). After taking chemotherapy treatment, the ECOG score of the chemotherapy group combined with cinobutacini obviously superior to that without cinobutacini. There were significant differences(p<0.05).Conclusion:1. Chemotherapy combined withcisplatin shows good effect in treating elderly advanced non-small cell lung cancer(NSCLC), and the adverse reaction happening rate increase by small degrees.2. Chemotherapycombined with Cinobutacini can improve the response rate in treating elderly advanced non-small cell lung cancer(NSCLC), but also reduce the happening rate of some adverse reactions, realize “Tumor-bearing survival” purpose, improve quality of patients life. |
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