贝伐单抗联合培美曲塞加顺铂治疗晚期非小细胞肺癌的临床观察

目的 比较贝伐单抗联合培美曲塞加顺铂（Avastin＋ PP）化疗方案与单用培美曲塞加顺铂（PP）化疗方案治疗晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）的临床疗效及不良反应.方法 收集2009年9月-2013年6月在我院应用贝伐单抗联合培美曲塞加顺铂治疗的晚期非小细胞肺癌患者32例为联合治疗组,取同时期、同TNM分期、同病理类型,采用培美曲塞加顺铂化疗方案的患者35例为对照组,所有患者均符合化疗要求.对照组：培美曲塞500 mg/m2,静脉滴注,d1;顺铂75 mg/m2静脉滴注,d1或d1 ～ d3;每21d为1个周期.联合治疗组：培美曲塞和顺铂用法及用量同对照组,贝伐单抗7.5 mg/kg静脉滴注,d1,每21d为1个周期.结果 联合治疗组和对照组疾病控制率分别为90.6％和60.0％（P＜0.05）;客观有效率分别为56.9％和25.7％（P＜0.05）;中位无进展生存期分别为7.3个月和4.2个月（P＜0.05）;中位总生存期分别为20.7个月和9.0个月（P＜0.05）,不良反应有骨髓抑制、恶心呕吐、肝肾功能损伤等,但两组差异无统计学意义.结论 贝伐单抗联合培美曲塞加顺铂化疗方案治疗晚期非小细胞肺癌在远期疗效和近期疗效方面均优于单用培美曲塞加顺铂化疗方案,且没有增加严重不良反应.

Clinical effect of combined bevacizumab,pemetrexed and cisplatin on advanced non-small cell lung cancer

Objective To compare the clinical effect of combined pemetrexed and cisplatin,and bevacizumab alone on advanced nonsmall cell lung cancer （NSCLC）.Methods Thirty-two advanced NSCLC patients who were treated with combined bevacizumab,pemetrexed and cisplatin （Avastin ＋PP） in our hospital from September 2009 to June 2013 served as an experimental group and 35 advanced NSCLC patients who were treated with combined pemetrexed and cisplatin（PP） served as a control group in this study.Patients in control group were treated with intravenous pemetrexed （500 mg/m2） on day 1 and cisplatin （75 mg/m2） on day 1 or on days 1-3,21 days as a cycle.Those in experimental group were treated with intravenous bevaoizumab （7.5 mg/kg） on day 1,pemetrexed （500 mg/m2） on day 1 and cisplatin （75 mg/m2） on day 1 or on days 1-3,21 days as a cycle.Results The disease control rate （DCR）and overall response rate （ORR） in the two groups were 90.6% and 60.0%,56.9% and 25.7%,respectively （P 〈 0.05）.The median progression-free survival （mPFS） time and median overall survival time （mOS） in the two groups were 7.3 months and 4.2 months,20.7 months and 9.0 months,respectively （P 〈 0.05）.No significant difference was found in adverse reaction between the two groups （P 〉 0.05） although bone marrow suppression,nausea,vomiting,hepatic and renal function damage occured.Conclusion The long-term and short-term effects of combined bevacizumab,pemetrexed and cisplatin are better than combined pemetrexed and cisplatin on advanced NSCLC with no severe adverse reaction.