培美曲塞与吉非替尼二线治疗晚期非小细胞肺癌的临床对比分析

目的探讨培美曲塞与吉非替尼单药治疗一线化疗失败的晚期非小细胞肺癌（NSCLC）的疗效及安全性，为NSCLC的二线临床用药提供一定的参考依据。方法将符合人组标准的83例患者随机分成培美曲塞组（41例）和吉非替尼组（42例）进行治疗观察，两组患者在性别、年龄、病理类型、分期，吸烟史等方面大致平衡。评价两组患者的疗效、无进展生存时间（PFS）、中位生存时间（MST）和不良反应。结果比较两组患者的中位PFS、中位OS、肿瘤分期、一线接受化疗方案个数等指标，两组差异均无统计学意义（P〉0．05），但吉非替尼组的血液学毒性明显低于培美曲塞组（P〈0．05），症状改善及生活质量改善优于培美曲塞组（P〈0．05）。结论在标准一线化疗失败的晚期NSCLC患者中，培美曲塞和吉非替尼单药二线治疗晚期非小细胞肺癌效率相近，但吉非替尼不良反应轻微，对症状和生活质量的改善率更高。

Efficacy comparison of Pemetrexed and gefitinib as second line treatment for advanced non-small cell lung cancer

Objective To compare the efficacy and safety of pemetrexed and gefitinib alone as a second line treatment for advanced non-small cell lung cancer （NSCLC） failed of first-line chemotherapy. Methods 83 patients failed in first-line treatment of NSCLC patients, 41 received pemetrexed and 42 patients received gefitinib. The gender, age, pathologic type, stage and smoking history in two groups were broadly balanced. The efficacy, progression-free survival time （ PFS）, median survival time （MST） and toxicity of the two groups were evaluated. Results Comparison of the median PFS and median OS, tumor stage, the number of front-line chemotherapy regimens accepted, and other indicators, the difference was not statistically significant （P 〉 0. 05 ）. The hematologic toxicity in gefitinib group was sigificantly lower than that of pemetrexed group and improvement rate of quality of life was higher in patients of gefitinib group than that of the pemetrexed group （P 〈 0. 05）. Conclusions In the advanced NSCLC patients with standard first-line chemotherapy treatment failure, pemetrexed and gefitinib shared the similar efficacy. Moreover, gefitinib is more suitable for the lower toxicity and the improvement rate of quality of life.