AP化疗方案治疗EGFR-TKI一线化疗失败非小细胞肺癌患者的疗效及对预后的影响

目的探讨培美曲塞联合顺铂(AP)化疗方案二线治疗表皮生长因子受体-酪氨酸激酶抑制剂(EGFRTKI)一线治疗失败非小细胞肺癌(NSCLC)患者的疗效及对预后的影响。方法将90例经EGFR-TKI一线化疗失败的NSCLC患者根据随机数字表法分为AP组(培美曲塞联合顺铂)和GP组(吉西他滨联合顺铂),每组45例。比较两组患者化疗近期疗效、不良反应、生活质量及生存情况。结果AP组患者客观缓解率(ORR)与疾病控制率(DCR)均略高于GP组,但差异均无统计学意义(P>0.05)。AP组患者白细胞减少、中性粒细胞减少、血小板下降发生率均低于GP组,差异均有统计学意义(P<0.05)。化疗前,两组患者Karnofsky评分比较,差异均无统计学意义(P>0.05);化疗后,两组患者Karnofsky评分均升高,差异均有统计学意义(P<0.05)。两组生存情况比较,差异无统计学意义(P>0.05)。结论二线AP和GP化疗方案对EGFR-TKI一线治疗失败NSCLC患者近期疗效、生存时间和生活质量影响相似,但AP方案不良反应较少,更为安全。

Curative effect of AP chemotherapy regimen in patients with non-small cell lung cancer after failure of first-line EGFR-TKI chemotherapy

Objective To investigate the effects of second-line chemotherapy regimen with pemetrexed combined with cisplatin(AP)on the curative effect and prognosis of patients with non-small cell lung cancer(NSCLC)after failure of first-line treatment with epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI).Method Ninety patients with NSCLC who failed the first-line chemotherapy with EGFR-TKI were enrolled and randomized according to a random number table as AP group(pemetrexed plus cisplatin)and GP group(gemcitabine plus cisplatin),with 45 cases in each.The short-term curative effects,adverse reactions,quality of life and survival of the two groups were compared.Result The objective response rate(ORR)and disease control rate(DCR)in the AP group were numerically higher than those in the GP group,while the difference was not significant(P>0.05).The incidence rates of leukopenia,neutropenia and thrombocytopenia in the AP group were significantly lower compared to GP group(P<0.05).There was no significant difference in regard to the scores of Karnofsky performance status scale(KPS)between the two groups before chemotherapy(P>0.05).After chemotherapy,the KPS scores were consistently improved in both groups,with statistically significant differences noted(P<0.05).Similar survival outcomes were observed in the two groups of patients(P>0.05).Conclusion The influences of second-line AP and GP chemotherapy regimens are similar in terms of short-term curative effects,survival time and quality of life of patients with NSCLC who have failed first-line treatment with EGFR-TKI,despite the AP regimen induces less adverse reactions and demonstrates higher safety.