培美曲塞与多西他赛二线随机分组治疗晚期非小细胞肺癌对比分析  

Therapeutic effect between Pemetrexed disodium and Docetaxel as second line chemotherapy on advance non-small cell lung cancer

作　　者：郑积华[1] 林金容[1] 谢波[1] 周娟[1] 徐志勇[1] 黄雪琴[1] 王仙赐[1] 张为民[1] 

机构地区：[1]广州军区广州总医院肿瘤科,广东广州510010

出　　处：《中华肿瘤防治杂志》2013年第5期368-370,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省科技计划(2009B030801035;2010B031600266)

摘　　要：目的:比较单药培美曲塞与多西他赛二线治疗化疗失败的晚期非小细胞肺癌的疗效及安全性。方法:应用单药培美曲塞或多西他赛治疗一线化疗失败的晚期非小细胞肺癌80例,培美曲塞组41例,多西他赛组39例。一线治疗方案为紫杉醇+顺铂或卡铂51例,吉西他宾+顺铂或卡铂21例,长春瑞宾+顺铂或卡铂8例。培美曲塞500mg/m2,多西他赛75mg/m2,均为静脉滴入且每21d重复1次。结果:培美曲塞组和多西他赛组的有效率分别为7.3%(3/41)和5.1%(2/39),差异无统计学意义,P>0.05。疾病控制率分别为46.3%(19/41)和33.3%(13/39),差异无统计学意义,P>0.05。培美曲塞组总生存期为3.1～15.6个月(中位生存时间7.6个月),肿瘤进展时间为4.9个月,11例生存时间>1年,1年生存率为26.8%(11/41)。多西他赛组总生存期为4.4～12.6个月(中位生存时间8.1个月),肿瘤进展时间为3.9个月,1例生存时间>1年,1年生存率为2.6%(1/39)。两组的主要毒副作用均为骨髓抑制、恶心、呕吐、头晕、头痛、脱发、腹泻、食欲减退、胸闷、腹痛、皮疹和四肢关节疼痛等,均可耐受。结论:单药培美曲塞或多西他赛二线治疗化疗失败的晚期非小细胞肺癌是安全及有效的,可以作为晚期非小细胞肺癌二线治疗。OBJECTIVE： To compare therapeutic effects between pemetrexed disodium and docetaxel as second line chemotherapy on advanced non-small cell lung cancer. METHODS： Eighty patients with advance non-small cell lung cancer resistant to first line chemotherapy were enrolled. Fifty-one cases had finished first line chemotherapy with paclitaxel and cis-platin or carboplatin （TP or TC）. Twenty-one cases had finished first line chemotherapy with gemzar and cis-platin or carboplatin （GP or GC） ,8 cases had carried out first line chemotherapy with nolvebin and cis-platin or carboplatin （NP or NC）. A dose of 500 mg/m2 pemetrexed disodium or 75 mg/mz docetaxel was respectively administered intravenously once every 21 days. RESULTS： The therapeutic effect rates in pemetrexed disodium group and docetaxel group were 7. 3% （3/41） and 5.1% （2/39） respectively （P〉0.05）. Disease control rates in pemetrexed disodium group and docetaxel group were 46.3%（19/41） and 33. 3% （13/39） respectively （P〉0. 05）. Overall survival in pemetrexed disodium group was 3.1--15.6 months （medium time 7.6 months） while overall survival in docetaxel group was 4.4--12.6 months（medium time 8. 1 months）. Time to progression in pemetrexed disodium group was 4.9 months while time to progression in do- cetaxel group was 3.9 months. Survival rates of one year were 26.8 % （11/41） in in pemetrexed disodium group and 2.6 % （1/39） in docetaxel group respectively. The main adverse effects in both group were slight and acceptable,which included neutrpeniarasharthragiaapeciadiarrheaanrexianauseavmitingdizzinessheadachechest distress and abdominal pain. No patients showed abnormality in liver or kidney function. No patients showed abnormality in electrocardiogram. CONCLUSION： Single pemetrexed disodium or do cetaxel as second line chemotherapy in the treatment of patients withadvanced refractory non-small cell lung cancer was safe and effect and both of them can be a choice of second line chemo therapy in the

关 键 词：癌 非小细胞肺 二线化疗 培美曲塞 多西他赛 

分 类 号：R734.2[医药卫生—肿瘤]