培美曲塞单药维持化疗治疗不同组织学类型晚期非小细胞肺癌的疗效观察  

Efficacy of Pemetrexed alone as Maintenance Chemotherapy for Advanced Non-small Cell Lung Cancer in Different Histological Types

作　　者：王莉莉[1] 蒋玉珑 柯红[1] 崔洁[1] 李传红[1] 

机构地区：[1]三峡大学第三临床医学院.葛洲坝中心医院,湖北宜昌443002

出　　处：《中国医院用药评价与分析》2013年第12期1103-1105,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的：探讨培美曲塞维持治疗晚期非小细胞肺癌（non-small—cell lung cancer，NSCLC）的疗效与肿瘤组织学类型的相关性。方法：57例Ⅲb～Ⅳ期NSCLC患者。均接受初期4个周期的诱导化疗且达到完全缓解和部分缓解，按组织学类型分为鳞癌组（22例）及非鳞癌组（35例）。2组患者均给予培美曲塞500mg／m2静脉滴注，21d为1个周期，并同时给予对症支持治疗。治疗2个周期后进行近期疗效评价；治疗中止时记录患者无进展生存时间及不良反应。结果：2组患者近期疗效比较，客观有效率（RR）（13．6％vs．22．9％）及疾病控制率（DCR）（54．5％vs．71．4％）均无显著性差异（P〉0．05）；但2组患者无进展生存期（PFS）中位数分别为3个月和5个月，有显著性差异（P〈0．05）。2纽不良反应发生率无差异，均较轻微。结论：晚期NSCLC组织学类型对培美曲塞维持治疗的疗效具有显著的影响，培美曲塞在非鳞癌患者的维持治疗中较鳞癌患者具有更好的疗效，且不良反应轻微，患者易耐受。OBJECTIVE：To explore the correlation between the efficacy of pemetrexed as maintenance therapy for advanced non-small cell lung cancer （NSCLC） and the histological types of tumor. METHODS ： A total of 57 patients with advanced NSCLC （stage Ⅲ b-Ⅳ ） showing complete or partial remission after receiving 4 cycles of induction chemotherapy were assigned to squamous cell carcinoma group （22 cases） and non-squamous cell carcinoma group （35 cases） based on differences in histological type. Both groups received pemetrexed 500 mg/m2 intravenously for 2 cycles （lasting 21 days for one cycle） plus symptomatic and supportive therapy. The short-term efficacy was evaluated after two cycles of maintenance treatment. The progression-free survival time （PFS） and adverse drug reactions were recorded at the completion of treatment. RESULTS ： The response rate （ 13.6% vs. 22. 9% ） and disease control rate （54. 5% vs. 71.4%） in squamous cell carcinoma and non-squamous cell carcinoma group showed no significant differences （P 〉 0. 05 ） ; however, significant differences were noted between the two groups in median PFS （3 months vs. 5 months, P 〈 0. 05 ）. The adverse drug reactions in both groups were mild showing no significant difference between the two groups. CONCLUSION： The histological type of advanced NSCLC were strongly associated with on the efficacy of maintenance therapy of pemetrexed. With mild adverse drug reactions, pemetrexed maintenance therapy is more effective for non-squamous cell carcinoma than for squamous cell carcinoma and it is well-tolerated in patients.

关 键 词：培美曲塞 维持治疗 非小细胞肺癌 组织学类型 

分 类 号：R979.1[医药卫生—药品]