Objective To evaluate the effect of comorbidity in the second line chemotherapy of elderly patients. Method 86 elderly cancer patients treated with the second line chemotherapy from 2010 to 2012 in PUMC Hospi-tal were analyzed retrospectively. The patients were divided into 3 groups according to the vary dysfunction of co-morbidity: no-dysfunction group (N), general dysfunction group (G) and serve dysfunction group (S). Result The disease control rates (DCR) of N group(n =20), G group (n =47) and S group (n =19) were 77.7%, 57.5% and 42.8% (P >0.1), the median progression-free survival (mPFS) were 9.8 months, 5.1 months and 3.7 months (P =0.05), the median overall survival were 23.7 months, 13.1 months and 10.5 months (P <0.05), respectively. The mPFS and mOS of S group were near reaching and reaching statistically significant decline compared with N and G groups. The incidences of hematological and non-hematological toxicity (≥3 grades) were 45% and 20% in N group, 31.9% and 23.4% in G group, 36.8% and 42.1% in S group, respectively. There were no significant differences among the 3 groups. Conclusion Most of elderly cancer patients with comorbidity can be tolerate of the second line chemotherapy and might obtain clinical benefits. But drug dose should be adjusted and adverse effects should be controlled carefully.%目的：评估不同功能损害的合并症对老年肿瘤患者二线化疗的影响。方法回顾性分析了86例住院接受二线化疗老年肿瘤患者的疗效、生存期和副作用。将患者根据合并症所致功能损害程度分为无合并症（N）、一般合并症（G）和严重合并症（S）三组。结果 N组20例，G组47例，S组19例，三组患者的疾病控制率分别为77.7%、57.5%和42.8%（P>0.1），中位无进展生存期（mPFS）分别为9.8个月、5.1个月和3.7个月（P=0.05），中位总生存期（mOS）分别为23.7个月、13.1个月和10.5个月（P<0.05）。与其他两组相比，S组患者mPFS的下降程度接近统计学意义，mOS的下降程度有统计学意义。N组、G组、S组的3级以上血液学毒性分别为45%、31.9%和36.8%，3级以上非血液学毒性分别为20%、23.4%、42.1%，各组差异无统计学意义。结论大多数伴有不同合并症的老年肿瘤患者可耐受二线化疗，并有不同程度的获益；但应注意调整剂量和控制毒副作用。
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