贝伐单抗联合培美曲塞治疗非小细胞肺癌临床观察  

Bevacizumab and pemetrexed combination therapy clinical observation of patients with non-small cell lung cancer

作　　者：张玉梅[1] 李春姗[1] 陈逸恒[1] 

机构地区：[1]广西中医药大学第一附属医院肿瘤内科,广西南宁530023

出　　处：《中华肿瘤防治杂志》2014年第1期51-54,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：广西自然科学基金(2010GXNSFA013213);广西青年基金(2011GXNSFB018104);广西中医药大学院级课题(p20091293)

摘　　要：目的:观察应用贝伐单抗与培美曲塞联合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:我院2009-09-05-2011-05-01收治72例晚期NSCIC患者,经一线GP(吉西他滨+顺铂)方案化疗4个周期获得疾病控制(CR+PR+SD)后,随机分为培美曲塞+贝伐单抗组(n=36)和培美曲塞组(n=36),观察两组疗效、无进展生存时间(progression-free survival,PFS)和中位生存期,以及不良反应及对生活质量的影响。结果:培美曲塞+贝伐单抗组和培美曲塞组的疾病控制率分别为83.4%和69.5%,两组比较差异无统计学意义,χ2=2.496,P=0.287。两组患者不良反应为白细胞下降、疲乏、血小板减少、贫血、转氨酶升高、胆红素升高、皮疹、黏膜炎、呕吐、腹泻、末梢神经炎、咯血、胃肠道穿孔、出血、动脉血栓栓塞和高血压,程度较轻均可以耐受,两组比较差异无统计学意义,P>0.05。培美曲塞+贝伐单抗组和培美曲塞组的中位PFS分别为4.6和3.9个月,差异有统计学意义,χ2=3.272,P=0.09;中位生存期分别为14和11个月,差异有统计学意义,χ2=6.372,P=0.012。结论:培美曲塞与贝伐单抗联合应用治疗晚期NSCLC有较好的有效性和安全性,可延长晚期NSCLC患者生存时间。OBJECTIVE：To observe the clinical efficacy of bevacizumab with pemetrexed in patients with advanced non-small cell lung cancer （NSCLC）. METHODS： From 2009-09-05 to 2011-05-01,72 cases of advanced NSCIC treated with first-line GP （ gemcitabine gemcitabine ＋ cisplatin ） chemotherapy for four cycles and got disease control （CR＋PR ＋ SD） were involved and divided into two groups, the pemetrexed ＋ bevacizumab group （n = 36） and training pemetrexed group （n~ 36）. Progression-free survival time and median survival time, as well as the adverse impact on quality of life were observed. RESULTS ： Disease control （CR＋ PR＋ SD） was 83.4in pemetrexed ＋ bevacizumab group and 69.5 % in pemetrexed group respectively. No statistically difference was shown between two groups （X2 = 2. 496, P = 0. 287）. The most commom adverse reactions were tolerable and they mainly were leucopenia, fatigue, thrombocytopenia, anemia, elevat- ed transaminases, elevated bilirubin, rash, mucositis, vomiting, diarrhea, peripheral neuritis, hemoptysis, gastrointestinal perforation,bleeding, arterial thromboembolism and hypertension. The differences of the adverse reactions in the two groups of patients were not statistically significant （P^0.05）. Median PFS was 4.6months and 3.9months （？（2 =3. 272, P=0.09） ,median survival were 14 months and 11 months （X2 = 6. 372,P 0. 012） and the difference was statistically significant. CONCLUSION： The combination of pemetrexed and bevacizumab have better efficacy in treatment of advanced NSCLC,and it can prolong the survival time of patients with advanced NSCLC.

关 键 词：癌 非小细胞肺 肺肿瘤 贝伐单抗 培美曲塞 药物疗法 药物耐受性 

分 类 号：R734.2[医药卫生—肿瘤]