吉非替尼联合培美曲塞治疗吉非替尼二线治疗进展后肺腺癌的疗效观察

目的观察吉非替尼联合培美曲塞治疗吉非替尼二线治疗进展后肺腺癌的疗效及安全性。方法选取2010年10月至2012年12月间74例一线化疗进展后给予吉非替尼治疗有效再次进展患者,随机分为观察组和对照组两组。观察组患者36例,采用培美曲塞500mg/m2,静脉滴注;吉非替尼250mg/d,口服,21d为1个周期;对照组患者38例,单用培美曲塞500mg/m2,静脉滴注,21d为1个周期。所有患者至少治疗2个周期。结果观察组近期治疗效果优于对照组,但两组差异无统计学意义;与对照组相比,观察组死亡率略低,中位进展时间和中位生存时间均更长,两组在死亡率、生存时间和进展时间方面比较,差异无统计学意义（P〉0.05）;两组不良反应差异无统计学意义（P〉0.05）。结论采用吉非替尼二线治疗进展后联合培美曲塞治疗非小细胞癌肺腺癌,其治疗效果明显,不良反应能耐受,有利于提高肺腺癌患者的生活质量,有望成为非小细胞肺癌（NSCLC）患者标准的三线治疗方案。

Clinical observation of treatment with gefitinib plus pemetrexed after progress of second-line therapy with gefitinib on lung adenocarcinoma

Objective To observe the clinical effect and safety of treatment with gefitinib plus peme- trexed after progress of second-line therapy with gefitinib on lung adenocarcinoma. Methods 74 cases, who received effective gefitinib therapy before the disease advanced after first-line chemotherapy from October 2010 to December 2012 in our department, were. randomly divided into observation group （36 cases） and control group （38 cases）. Patients if former group were given pemetrexed （ in intravenous drip, 500 mg/m2 ） and ge- fitinib （in oral, 250 rag/day） with 21 days as a cycle. The others were given pemetrexed only （in intravenous drip, 500 mg/m2 ） with the same days as a cycle. All patients received therapy at least for 2 cycles. Results The clinical effects of observation group were superior to control group, but there was no significant differ- ence. Compared with control group, the mortality of control group was slightly lower, and the middle of fol- lowed-up time and the middle of no progression time were longer, however there was no significant difference on these three aspects between the two group. There also was no significant difference between two groups for ad- verse reactions （P 〉 0. 05）. Conclusions The treatment with gefitinib plus pemetrexed after failure of second- line therapy with gefitinib obtained obvious treatment effect and little side effects, and improved patients＇ life quality and endurance. It is expected to become the third-line therapy regimen for NSCLC.