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近年多组大规模的随机对照研究已经证实:放化疗对于老年晚期NSCLC患者好于最佳支持治疗(BSC),放化疗组的有效率、中位生存期、一年生存率显著高于BSC组,但老年人伴随着年龄的增长器官功能衰退、药代酶活性下降等生理因素,常合并其他疾病等原因,其药效学和药动学也随之发生变化,老年NSCLC放化疗的潜在毒性危险可能增加,治疗耐受性较差,综合治疗可能带来较多的并发症,甚至高的治疗相关死亡率。中医学认为化疗副反应主要表现为气血亏损、脾胃失调及肝肾虚损等症候群,放疗副反应的症候群以热象较重,属热毒之邪耗气伤阴,进而灼津烁血以致气血、肌肤、脏腑受损的火郁、燥结、热毒症候较多。中医药在减轻放化疗的毒副作用、提高老年患者对放化疗的耐受性等方面有明显优势。
In recent years, many large-scale randomized controlled studies have confirmed: radiotherapy and chemotherapy in elderly patients with advanced NSCLC better than the best supportive care (BSC), radiotherapy and chemotherapy group, the effective rate, median survival, one year survival was significantly higher than the BSC group , But the elderly with age, organ dysfunction, decreased enzyme activity and other physiological factors, often combined with other diseases and other reasons, its pharmacodynamics and pharmacokinetics also will change, the potential of chemotherapy in elderly NSCLC toxicity Danger may increase, treatment tolerance is poor, combination therapy may lead to more complications, and even high treatment-related mortality. Chinese medicine believes that the main side effects of chemotherapy for qi and blood loss, spleen and stomach and liver and kidney deficiency and other syndromes, radiotherapy side effects of the syndrome with a heavier heat, is a heat of the evil consumption gas Qi Yin, Blood, skin, organs impaired Huyu, dry knot, heat toxicity more. Traditional Chinese medicine has obvious advantages in alleviating the toxic and side effects of radiotherapy and chemotherapy and improving the tolerance of radiotherapy and chemotherapy in elderly patients.