两种二线化疗方案治疗晚期非小细胞肺癌疗效的比较

 目的 比较国产培美曲塞二钠或多西他赛单药用于治疗一线化疗失败的晚期非小细胞肺癌（NSCLC）患者的疗效与安全性。方法 86例既往一线化疗失败或不能耐受的ⅢB或Ⅳ期NSCLC患者分别入培美曲塞二钠组（A组）或多西他赛组（B组），28例患者接受培美曲塞二钠500 mg·m-2治疗，58例患者接受多西他赛75 mg·m-2治疗。入组患者至少接受2个周期以上化疗。结果 入组的86例患者均可评价疗效，治疗1年后随访83例，A组27例，B组56例，失访3例。A组和B组的总有效率分别是7.14%和10.34%，疾病控制率分别是67.86%和70.69%，1年的生存率分别为44.44%和55.36%，中位生存期为11.2个月和12.2个月，两组的不良反应主要表现在骨髓控制、肝损伤、恶心/呕吐、乏力及皮疹。A组骨髓抑制的发生率明显低于B组，但皮疹的发生率却明显高于B组。结论 对于既往一线化疗失败或不能耐受的晚期NSCLC患者，单药使用培美曲塞二钠或多西他赛进行化疗疗效相似；不良反应各有特点，患者都可以耐受，值得临床推广。

Combination of Short-Term Efficacy of Two Second-Line Regimins in Patients with Advanced Non-Small-Cell Lung Cancer

OBJECTIVE To compare the short-term efficacy and safety of domestic pemetrexed and docetaxel singly used in treatment of patients with advanced non-small-cell lung cancer(NSCLC) who previously failed with first-line chemotherapy. METHODS 86 patients with stage-ⅢB or stage-Ⅳ NSCLC who couldn't bear or failed in previous first-line chemotherapy were assigned to two groups: 28 patients received pemetrexed 500 mg·m-2 and 58 patients received docetaxel 75 mg·m-2. All eligible patients received 2 cycles chemotherapy at least. RESULTS 86 patients were evaluable for efficacy. Overall response rates were 7.14% vs 10.34% and disease control rates were 67.86% vs 70.69% in pemetrexed and docetaxel groups respectively. The principal toxic reactions were myelosuppression, liver injury nausea/vomiting, fatigue and rash. Patients receiving pemetrexed were less likely to have myelosuppression while patients receiving docetaxel wess less likely to have rash. CONCLUSION Treatment with pemetrexed and docetaxel resulted in clinically equivalent efficacy in treatment of patients with advanced non-small-cell lung cancer(NSCLC) who previously failed with first-line chemotherapy; moreover, the adverse effect of the two agents are in their own characteristics and tolerated. Overall, the two chemotherapies deserved recommendation when available.