放疗联合培美曲塞化疗和厄洛替尼维持治疗局部晚期肺非鳞癌的疗效观察  

Radiation combined with Pemetrexed chemotherapy and Erlotinib hydrochloride for maintenance treatment of local advanced non-squamous cell lung cancer

作　　者：梁彩霞[1] 罗海涛[2] 胡建新[2] 古伟光[2] 贺志仁[2] 徐敏[2] 

机构地区：[1]南方医科大学附属南海医院呼吸内科,广东佛山528200 [2]南方医科大学附属南海医院肿瘤科,广东佛山528200

出　　处：《海南医学》2014年第19期2825-2827,共3页Hainan Medical Journal

基　　金：佛山市医学类科技攻关项目(编号:201208175)

摘　　要：目的评价三维适形放疗同步培美曲塞化疗和厄洛替尼维持治疗局部晚期肺非鳞癌的近期疗效及毒副反应。方法 58例局部晚期肺非鳞癌患者随机分为治疗组30例和对照组28例,对照组行三维适形放疗（3DCRT）当天接受TP方案（紫杉醇175 mg/m^2d1,DDP 20 mg/m^2d1～4）化疗1个疗程,第三周再按该方案化疗;放疗结束后每3周按该化疗方案化疗4个疗程。治疗组行三维适形（3DCRT）放疗当天接受PD方案（培美曲塞500 mg/m^2,顺铂20 mg/m^2d1～4）化疗1个疗程,第三周再按该方案化疗;放疗结束后每3周按该化疗方案化疗4个疗程后,口服厄洛替尼至病情进展。结果所有患者均能完成治疗,无中间停药病例,放疗后都可继续进行不同时间的靶向药物治疗,中位用药时间21.3个月。治疗组CR 7例（23.3%）,PR例19例（63.3%）,RR为86.7%,CBR为93.3%。对照组CR 3例（10.7%）,PR例13例（46.4%）,RR为57.1%,CBR为67.9%。治疗组CR、PR、RR、CBR明显高于对照组,特别是RR、CBR,其差异均具有统计学意义（P〈0.05）。治疗组在白细胞、血小板减少和恶心呕吐等不良反应方面显著比对照组少,差异具有统计学意义（P〈0.05）。所有不良反应经处理后均能顺利完成治疗。结论三维适形放疗同期培美曲塞化疗和厄洛替尼维持治疗局部晚期肺非鳞癌,近期疗效显著,且毒副作用较少,是一种安全而有效的治疗手段。Objective To evaluate the short-term curative effect and adverse reactions of the three-dimensional conformal radiotherapy（3DCRT） combined with Pemetrexed chemotherapy and Erlotinib hydrochloride for maintenance treatment of local advanced non-squamous cell lung cancer. Methods All 58 cases of patients with local advanced non-squamous cell lung cancer diagnosed in our hospital were enrolled and randomly divided into treatment group（30 cases） and control group（28 cases）. In the control group, one cycle of TP protocol（Paclitaxel 175 mg/m^2, d1;Cisplatin 20 mg/m^2d 1～4） started from the 1^st day, which was repeated at the third week. Another cycle was performed every 21 days after the last cycle（totally 4 cycles）. In the treatment group, one cycle of DP protocol（Pemetrexed 500 mg/m^2, Cisplatin 20 mg/m^2, both d1～4） started on the 1stday, which was also repeated at the third week. Totally 4 cycles were performed, and Erlotinib hydrochloride was given at the end of 3DCRT according to disease progression. Results All patients underwent the entire treatment duration. The median time of duration was 21.3months. For the treatment group, the complete remission rate（CR）, partial remission rate（PR）, the residual tumor rate（RR） and CBR were 23.3%（7 cases）, 63.3%（19 cases）, 86.7% and 93.3% respectively. And for the control group, CR,PR, RR and CBR were 10.7%（3 cases）, 46.4%（13 cases）, 57.1% and 67.9% respectively. CR, PR, RR and CBR in the treatment group were higher than those in the control group with statistical differences（P〈0.05）. Meanwhile, incidences of leukopenia, thrombocytopenia, nausea and vomiting in the treatment group were significantly lower than those in the control group（P〈0.05）. All adverse reactions after treatment can be successfully controlled. Conclusion With distinct short-term curative effect and less adverse reactions, 3DCRT combined with Pemetrexed chemotherapy and Erlotinib hydrochloride is regarded to be a safe and effective treatm

关 键 词：局部晚期肺非鳞癌 三维适形放疗 培美曲塞 厄洛替尼 维持治疗 

分 类 号：R734.2[医药卫生—肿瘤]