会计学老年肺癌特点一线化疗：单药还是双药？靶向治疗：一如既往还是小心求证？二线治疗老年肺癌年龄的界定老年人的药动学特点老年肺癌特点老年晚期NSCLC是否应该化疗老年肺癌特点一线化疗：单药还是双药？单药治疗非铂双药化疗含铂双药化疗靶向治疗：一如既往还是小心求证？ComparisonofEfficacyandSafetyofSingle-agentandDoubletChemotherapyinAdvancedNon-smallCellLungCancerintheElderly:AMeta-analysis.单药化疗Effectsofvinorelbineonqualityoflifeandsurvivalofelderlypatientswithadvancednon-smallcelllungcancerPhaseIIIstudyofdocetaxelcomparedwithvinorelbineinelderlypatientswithadvancednon–small-celllungcancer:ResultsofWestJapanThoracicOncologyGrouptrial（WJTOG9904）WJTOG9904确定了多西紫杉醇单药治疗老年进展期NSCLC的地位非铂双药化疗Gemcitabineplusvinorelbineyieldsbettersurvivaloutcomethanvinorelbinealoneinelderlypatientswithadvancednon-smallcelllungcancer.ASouthernItalyCooperativeOncologyGroup(SICOG)phaseIIItrialChemotherapyforelderlypatientswithadvancednon-small-celllungcancer:theMulticenterItalianLungCancerintheElderlyStudy(MILES)phaseⅢrandomizedtrialSurvivalcurvesforelderlypatientswithadvancedNSCLCenrolledinMILESGemcitabinewitheitherpaclitaxelorvinorelbinevspaclitaxelorgemcitabinealoneforelderlyorunfitadvancednon-small-celllungcancerpatients（SICOG9909）Weeklydocetaxelversusdocetaxel/gemcitabineinthetreatmentofelderlyorpoorperformancestatuspatientswithadvancednonsmallcelllungcancer:arandom-izedphaseⅢtrialoftheMinniePearlCancerResearchNetworkCancer,2007,110(9):2027-2034Cancer,2007,110(9):2027-2034Docetaxel(D)plusgemcitabine(G)comparedwithGinelderlypatientswithadvancednon-smallcelllungcancer(NSCLC):PreliminaryresultsofarandomizedphaseIIIHellenicOncologyResearchGrouptrial（HORG）两组病人在MST(15.9mvs.12.2m;p=0.072)、中位TTP(3.17mvs.2.53m;p=0.227)和客观缓解率(28.3%vs.11.6%;p=0.066)无差别。IADL评分<7病人MST(10.13vs.17.3m;p=0.025)和中位TTP(2.13vs.4.7m;p=0.023)显著低于IALD评分为7-8病人。两组出现3/4级粒细胞减少分别为8.1%和6.6%(p=0.545)。研究者认为DG方案相对G单药方案治疗老年NSCLC不能改善生存时间和疾病进展时间，但是无论应用双药还是单药，IALD评分高的病人能从化疗中受益。含铂双药化疗Cisplatinplusgemcitabineorvinorelbineforelderlypatientswithadvancednon-small-celllungcancer:theMILES-2pstudiesJClinOncol,2007,25:4663-4669JClinOncol,2007,25:4663-4669RandomizedphaseI