The incidence of lung cancer in China increases significantly. The incidence of non-small cell lung cancer accounts for about 70% of lung cancers. 60% -70% of patients are diagnosed in late period. At the same time, about 50% of such patients are over the age of 65. Combination chemotherapy of platinum drugs and local radiotherapy are the main ways for advanced NSCLC. But the drugs in combining chemotherapy are cytotoxic. There are clear and synergistic adverse reactions. In addition to elderly patients with body conditions are deteriorating, and they often have other basic disease, so some patients can not tolerate or refused to combination chemotherapy because of fear. In clinical trials, they can only have support, symptomatic and palliative care. The treatment method is negative.
Before the treatment, the head, chest CT or MRI, bone scan, abdominal ultrasound, blood, liver and kidney function, ECG and other tests need to be taken. During chemotherapy on a regular basis to review the ultrasound, blood, liver and kidney function, ECG and other tests. Every two cycles of measurable lesions, CT scan or MRI. Unified assessment of the objective criteria of efficacy according to the WHO criteria: complete remission, partial remission, stability and progress. Effective rate of CR + PR; efficacy need to maintain more than four weeks. Duration of remission for the first time to evaluate the time of the PR or CR until disease progression, time to tumor progression for the start of treatment until the time of tumor progression, overall survival to begin treatment until the time of death from any cause. Evaluation of adverse reactions were classified into the degree of 0-IV according to the WHO anti-cancer drug toxicity.
Docetaxel is a semisynthetic taxane pharmaceutical raw material. It is cell cycle-specific drug by promoting tubule polymerization stabilized microtubules, and inhibition of its solution of poly to make the number of free small tube of a significant reduction, inhibition of tumor cell division, will The cells were blocked at M phase; its mechanism of action the same role in stabilizing microtubules paclitaxel. Induction of apoptosis may be an important mechanism of chemotherapy drug-induced cytotoxicity, ble-2 protein is an apoptosis inhibitor, docetaxel is an effective phosphorylation induced by agents, including lung cancer in induced entity within the protein over-expression of tumor cell apoptosis; docetaxel for the overexpression of p-glycoprotein in many human tumor multidrug resistance associated protein with anticancer activity. In the clinical treatment of NSCLC, docetaxel as second-line treatment of recurrent or metastatic lung cancer, with good effect. In part as first-line treatment, docetaxel single-agent’s efficiency is from 21.7% to 38%.
Docetaxel’s efficiency in patients with single-agent first-line chemotherapy is about f 25.0%. A median time is 6.5 months, median rrP is5.6 months. The median 0s is 11.4 months, one year survival rate was 38.2%. KPS and weight gain and pain relief also shows that single-agent chemotherapy of docetaxel significantly improves the quality of life of elderly patients with NSCLC. Common adverse reactions are allergic reactions. In recent years, regular preventive doses of dexamethasone, such reaction can be controlled. Followed by bone marrow suppression, gastrointestinal reactions, and liver function damage and nervous system response, are to a lesser extent, symptomatic treatment can be alleviated.
In summary, single-agent docetaxel chemotherapy for elderly NSCLC can prolong survival period and improve quality of life. There are less adverse drug reactions. Compliance and safety of the patients are also guaranteed.
Source:http://www.cospcn.com
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