期刊 比较培美曲塞维持治疗与二线治疗晚期非小细胞肺癌的临床疗效  

The Clinical Curative Effect Comparison of Maintenance Chemotherapy and Second-line Chemotherapy with Pemetrexed in Non-small Cell Lung Cancer

作  者:张永健[1] 金小寅[1] 游庆军[1] 

机构地区:[1]无锡市第四人民医院

出  处:《中外医学研究》2012年第32期9-11,共3页Chinese and Foreign Medical Research

The Clinical Curative Effect Comparison of Maintenance Chemotherapy and Second-line Chemotherapy with Pemetrexed in Non-small Cell Lung Cancer

摘  要:目的:评价晚期非小细胞肺癌(NSCLC)诱导化疗获益后二线化疗药物培美曲塞(PEM)应用于早期维持治疗与延迟二线治疗的疗效。方法:81例晚期NSCLC患者(ⅢB或Ⅳ期)均接受以铂类为基础的一线治疗4~6周期后,病情获得缓解或稳定的患者随机分为早期组(n=58)和延迟组(n=23)。所有患者均予PEM(500mg/m2,第1天)联合最佳支持治疗,21d为一周期,同时维生素B12、叶酸、地塞米松预防毒副反应。结果:早期组的中位无进展生存期(PFS)较延迟组显著延长(6.8±0.7个月比2.7±0.5个月,字2=54.878,P<0.001),而中位总生存期(OS)较延迟组有所延长(14.7±0.6个月比12.4±0.5个月,字2=3.018,P=0.082),但差异无统计学意义,腺癌患者中位OS较鳞癌患者显著延长(16.5±0.6个月比11.2±0.5个月;字2=14.734,P<0.001),两组间的药物的安全性与毒性发生率差异无统计学意义。结论:提早应用二线化疗药物培美曲塞维持治疗明显延长患者的PFS,并且没有增加毒性反应,腺癌患者可获得较好的生存期。

Objective : To assess the efficacy and safety of pemetrexcd administered either immediately after front-line treatment for advanced nonsmall-eell lung eancer(NSCLC) or at disease progression.Methods : 81 patients with stage Ⅲ B or Ⅳ NSCLC who had not progressed on four to six cycles of platinum-based chemotherapy were randomly assigned either to an immediate pemctrexed group(n=58) or to a delayed pemetrexed group(n=23).All patients receive pemetrexed(500 mg/m^2, on day i every 21 days) plus best supportive care, patients also received oral dexamethasone, oral folic acid and i.m.vitamin B12 supplementation to reduce toxicity.Results : Median PFS for immediate pemetrexed was significantly greater than for delayed pemetrexed (6.8 ± 0.7 months vs 2.7± 0.5 months ; X^2=54.878, P〈0.001).Median OS for immediate docetaxel (14.7 ± 0.6 months) was greater than for delayed pemetrexed (12.4 ± 0.5 months), but the difference was not statistically significant(x2=3.018, P=0.082).However, overall survival was statistically superior for adenocarcinoma subgroup versus squamous subgroup(16.5 ± 0.6 months vs 11.2 ± 0.5 months ; X^2=14.734, P〈0.001).Toxicity was not statistically different between two groups.Conclusion : Pcmetrexed was administered immediately after front-line therapy, which can extended significantly PFS, without increasing toxicity.The patients with adenocareinoma histology have the survival advantage.

关 键 词:非小细胞肺癌 维持治疗 二线治疗 培美曲塞 

Non-small cell lung cancer   Maintenance chemotherapy   Second-line chemotherapy   Pemetrexed 

分 类 号:R563[医药卫生—呼吸系统]

 

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