阿帕替尼联合培美曲塞治疗老年晚期非鳞非小细胞肺癌的疗效观察

  目的  观察培美曲塞与阿帕替尼联合用于老年晚期非鳞非小细胞肺癌的疗效。  方法  选取2016年1月到2017年6月在青岛市市立医院就诊的老年晚期非鳞非小细胞肺癌38例，均为一线或二线治疗失败者，入组人群要求年龄≥65岁、体力状况评分0~2分、预计生存期>3个月。将患者分为试验组（n=18）及对照组（n=20）。试验组行培美曲塞与阿帕替尼联合治疗，具体为:培美曲塞500 mg/m2 d1，阿帕替尼250 mg/d，d1~21，21d为1个治疗周期，对照组行单药培美曲塞，直到病情进展或不能耐受不良反应。该研究经青岛市市立医院医学伦理委员会审查批准。  结果  试验组和对照组的疾病控制率分别为72.2%和35%，具有统计学差异（χ2=5.265，P=0.022）；试验组和对照组的中位无进展生存期是5.7个月（95% CI:2.8~8.6）和3.1个月（95% CI:2.7~3.5），两者比较差异有统计学意义（χ2=4.011，P=0.045）；发生手足综合征、高血压的比率有统计学差异（P=0.007，P=0.016），多数为1~2级。  结论  培美曲塞与阿帕替尼联合用于老年晚期非鳞非小细胞肺癌疗效明确，不良反应可控。 

Efficacy of apatinib plus pemetrexed for advanced non-squamous non-small cell lung cancer in elderly patients

  Objective  To examine the efficacy and safety of pemetrexed plus apatinib for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC) in elderly patients.  Methods  Between January 2016 and June 2017, 38 elderly patients with advanced non-squamous NSCLC from Qingdao Municipal Hospital were examined. All patients received first- or second-line therapy. The inclusion criteria were an age of ≥ 65 years, physical status score of 0-2, and expected survival time of >3 months. Eighteen patients were assigned to the test group, and the remaining 20 patients were assigned to the control group. The patients in the test group were treated with pemetrexed plus apatinib, pemetrexed 500 mg/m2 on day 1 and apatinib 250 mg/d on days 1-21. The control group received pemetrexed in a 21-day cycle until the disease progressed or intolerable adverse reactions developed. The study was reviewed and approved by the medical ethics committee of Qingdao Municipal Hospital.  Results  The disease control rates in the test and control groups were 72.2% and 35%, respectively, with a statistically significant difference (χ2=5.265, P=0.022). The median progressionfree survival time (PFS) in the test and control groups were 5.7 months95% confidence interval (CI):2.8-8.6] and 3.1 months (95% CI:2.7-3.5), with a statistically significant difference (χ2=4.01, P=0.045). The difference in the incidence of hand-foot syndrome and hypertension between the two groups was statistically significant (P=0.007 and P=0.016, respectively), with side effects of 1 or 2 degree in most cases, which was acceptable.  Conclusions  Pemetrexed plus apatinib has a definite curative effect on advanced NSCLC, with controllable adverse reactions.