培美曲赛联合奥沙利铂二线治疗晚期非小细胞肺癌的回顾性研究

目的]评价培美曲赛联合奥沙利铂用于晚期非小细胞肺癌二线治疗时的安全性和有效性。方法2007年1月～2009年1月,一线治疗失败的晚期非小细胞肺癌患者中,一部分采用了培美曲赛单药或培美曲赛联合奥沙利铂化疗作为二线治疗,回顾他们的病历,并比较两组患者的临床特征,使用Kaplan-Meier法和时间等级检验分析两组之间生存期的差别。结果]共79人纳入分析,34人使用PO方案(培美曲赛500mg/ml2d1+奥沙利铂125mg/m21,每21d重复),45人使用培美曲赛单药化疗。两组耐受性都较好,没有治疗相关性死亡发生,粒细胞减少是最常见的毒性反应。PO组的缓解率和肿瘤控制率分别为15.2%和63.6%,单药组则分别为11.1%、47.5%。PO组中位进展时间和中位生存期分别是18周(95%可信区间:13.72～22.28周)和31周(95%可信区间:15.56～46.44周),明显好于单药组(P值分别为0.002、0.006)。结论]在晚期非小细胞肺癌的二线治疗中培美曲赛联合奥沙利铂化疗方案表现出与培美曲塞单药化疗方案相似的安全性和缓解率,生存期显著延长。

A RETROSPECTIVE STUDY OF PEMETREXED COMBINED WITH OXALIPLATIN AS THE SECOND LINE TREATMENT FOR ADVANCED NON-SMALL CELL LUNG CANCER

Objective]To evaluate the therapeutic effect and toxicity of combination of pemetrexed and oxaliplatin as the second-line treatment of patients with advanced non-small cell lung cancer.Methods]Between January 2007 and January 2009,some patients with metastatic non-small cell lung cancer failed to the prior chemotherapy accepted pemetrexed or combination of pemetrexed and oxaliplatin as second-line treatment,their medical records were reviewed.Chi-Square test was used to compare clinical characteristics between two groups.Kaplan-Meier curve and Log-Rank test were used to analyze the overall survival and the time to progress.Results]Seventy-nine patients were involved,34 of them were treated with the regimen PO(pemetrexed 500mg/m2 day1 plus oxaliplatin 125mg/m2 day1,repeated every 21 days).Another 45 patients were administered pemetrexed only.The most common toxicity was neutropenia.The response rate(15.2% vs.11.1%)and tumor control rate(63.6% vs.47.5%)were observed in the two groups.The median time to progression and overall survival of the PO group were 18 weeks(95%CI:13.72-22.28 weeks)and 31 weeks(95%CI:15.56-46.44 weeks),significantly longer than those of pemetrexed group(P=0.002 and 0.006,respectively).The two groups were both well-tolerated,and no therapy related death happened.Conclusion]Combination of pemetrexed and oxaliplatin for advanced non-small cell lung cancer was safe and had similar response rate comparing with the single pemetrexed regimen,and significantly prolong overall survival.