The Study Of First-line Chemotherapy Of GN/Platinum Doublets/Single Regime For The Elderly Advanced Non-small Cell Lung Cancer

Background:Worldwide, with the increasing morbidity and mortality of elderly patients withNSCLC, the elderly patients with NSCLC gradually become a common concern onthe cancer community. In the past, many elderly patients with advanced non-smallcell lung cancer without treatment, because think treatment toxicity may outweigh thebenefits of it. However, it is clear that patient with treatment might be of benefit now.Some meta-analysis pointed out that chemotherapy compared to best supportivetreatment, survival has a slight increase in[1], since that chemotherapy has become thefirst treatment of advanced NSCLC. However, elderly patients because of decline inphysiological function and complications, tolerance to chemotherapy is poor, andthey always do the clinical study is less, many clinical studies exclude elderly patients,the results also cannot be extrapolated to elderly patients, so far there is no standardsolutions for the treatment of elderly NSCLC. In recent years, studies of elderlyNSCLC treatment is becoming more and more attention. Therefore, correctunderstanding of the role of chemotherapy survival advantage in elderly patients, it isof great significance.Objective:Analysis of the curative effect of two drugs regime non-platinum gemcitabinecombined vinorelbine for elderly advanced non-small cell lung cancer (non-smallcell lung cancer, NSCLC), adverse reaction and the status of the survival benefit, soas to explore the efficacy and tolerability of more suitable for elderly patients withadvanced NSCLC chemotherapy regimens.Methods:108cases confirmed by pathology or cytology of the70-year-old or olderpatients with stage IIIB~IV NSCLC,respecitively received chemotherapy whithgemcitabine/vinorelbine of doublet regimes non-platinum-based, the third generationof chemotherapy drugs combined platinum chemotherapy, the single-agentchemotherapy with third generation of chemotherapy drugs. Then evaluate the recent curative effect, symptom remission rate, adverse reactions, and overall survivalbenefit, follow-up observation for survival analysis.Results:49patients with tumor associated symptoms relief and designed.the GN group,the doublet with platinum group and single drug group,the symptom remission ratewas52.40%,48.5%,50.0%,respectively. the GN group objective response rate (ORR)50.0%, disease control rates (DCR)85.0%; Platinum-based doublet group objectiveresponse rate (ORR)34.2%, disease control rates (DCR)92.1%; Single drug groupobjective response rate (ORR)33.3%, disease control rates (DCR)66.7%. Main III~IV degree of adverse reactions is bone marrow suppression, kidney function damage,gastrointestinal reaction and so on, leucopenia is the most common. The incidence oftoxicity in doublet with platinum-based group is higher than the GN group, differencewas statistically significant (X2=4.884, P=4.884).The toxicity reaction rates aresimilar between the GN group and the single drug, there was no statisticallysignificant difference (X2=0.453, P=0.453). Doublet with platinum group in thegastrointestinal tract reaction and renal damage rates is higher than the other twogroups.Conclusion:1.The side effects of doublet regimes wiht platinum is more serious thannon-platinum-based, especially obvious in the renal toxicity and gastrointestinalreaction.2.The curative effect gemcitabine combined vinorelbine as first-line treatment inelderly patients with advanced NSCLC is affirm, close to the doublet with platinum,can effectively alleviate the tumor associated symptoms, disease control, and toxicitycan be tolerated.3.patients with poor ECOG score, aged, kidney dysfunction, should not bereceived doublet regimes wiht platinum,can give priority to with non-platinum-basedchemotherapy of gemcitabine plus vinorelbine.