摘要
目的观察培美曲塞单药或联合铂类二线治疗晚期非鳞非小细胞肺癌(NSCLC)的疗效及不良反应。方法回顾性分析2011年3月至2013年6月一线治疗失败晚期非鳞NSCLC患者共309例。其中接受培美曲塞单药治疗118例,接受培美曲塞联合铂类治疗191例。单药组:培美曲塞500 mg/m2 d1;联合组:培美曲塞500 mg/m2 d1+顺铂75 mg/m2 d1或卡铂AUC=5 d1。结果完全缓解(CR)2例,部分缓解(PR)56例、稳定(SD)99例、疾病进展(PD)152例。单药组和联合组客观缓解率(ORR)分别为15.3%和20.9%(P=0.274),疾病控制率(DCR)分别为38.1%和57.6%(P=0.001),1年生存率分别为42.4%和43.5%(P=0.853),中位无进展生存期(PFS)分别为3.7个月和5.0个月(P=0.000),中位总生存时间(OS)分别为11.4个月和12.0个月(P=0.091)。单药组和联合组的最主要不良反应均为Ⅰ/Ⅱ度中性粒细胞减少、贫血、乏力和消化道反应,但单药组的血液毒性、消化道反应和乏力的发生率明显低于联合组(P<0.05)。结论培美曲赛单药治疗一线失败晚期NSCLC有较好的疗效,安全性高,尤其对于ECOG评分较差的患者不会降低生存率。
Objective To evaluate the efficacy and adverse effects of pemetrexed monotherapy or pemetrexed in combination with platinum for the treatment of advanced non-squamous non-small cell lung cancer （NSCLC）. Methods A total of 309 patients with advanced non-squamous NSCLC confirmed with pathology or cytology were devided single-agent group （patients received pemetrexed 500 mg/m2 on day 1） and combination group （patients received pemetrexed 500 mg/m2 on day 1 and cisplatin 75 mg/m2 or carboplatin A UC=5 on day 1 by intravenous infusion, administrated every 3 weeks for 2 to 6 cycles）. Results Among 309 cases, complete remission （CR） was 2 cases, partial remission （PR） was 56 cases, stable disease （SD） was 99 cases, and disease progression （PD） was 152 cases. Objective response rate （ORR） of singe-agent group and combination group were 15.3% and 20.9% （P=0.274） respectively. Disease control rate （DCR） of singe-agent group and combination group were 38.1% and 57.6% （P=-0.001）. 1-year survival rate of singe-agent group and combination group were 42.4% and 43.5% （P=0.853）. The median progression-free survival （PFS） of singe-agent agent group and combination group were 3.7 and 5.0 months （P=0.000）. Overall survival （OS） of singe-agent group and combination group were 11.4 and 12.0 months （P=0.091）. The main adverse reactions of two groups were grade 1/2 neutropenia, anemia,fatigue and gastrointestinal reaction. Hematological toxicity, gastrointestinal reaction and fatigue of single-agent group were significantly lower than those of combination group （P 〈 0.05）. Conclusion Pemetrexed monotherapy has curative effect and safe for advanced NSCLC patients.
出处
《世界临床药物》
CAS
2015年第8期529-533,共5页
World Clinical Drug
基金
上海市胸科医院科技发展基金项目(YZ14-10)
上海市胸科医院科技发展基金重大重点项目(2014YZDC10101)
上海市自然基金项目(12ZR1428800)
上海市科委基础重点项目(11JC1412200)
关键词
培美曲塞
非小细胞肺癌
二线治疗
pemetrexed
non-small cell lung cancer
second-line therapy
