培美曲塞联合序贯与同步放疗治疗中晚期非小细胞肺癌疗效的对比研究  

Comparative study of Pemetrexed combined with radiotherapy,concurrent chemoradiotherapy and sequential chemoradiotherapy in patients with advanced non-small cell lung cancer

作　　者：陈晓东[1] 杨泽辉[2] 段琼玉[1] 

机构地区：[1]中国医科大学附属盛京医院滑翔院区肿瘤二科,辽宁沈阳110022 [2]中国医科大学附属盛京医院滑翔院区第二呼吸科,辽宁沈阳110022

出　　处：《现代肿瘤医学》2015年第18期2606-2609,共4页Journal of Modern Oncology

摘　　要：目的：比较培美曲塞联合同步与序贯放疗治疗中晚期非小细胞肺癌疗效及不良反应。方法：67例初次治疗的中晚期非小细胞肺癌患者接受培美曲塞联合放疗,分别采用同步放化疗和序贯放化疗。化疗方案为培美曲塞单药500mg/m2,第1天,21天为1个周期,共2个周期。放疗采用多叶光栅技术,直线加速器6MV X线放疗,2Gy/次,5次/周,总剂量DT=66Gy,引流区淋巴结总剂量为58~60Gy。结果：同步组总有效率（76.5%,26/34）高于序贯组（54.5%,18/33）,同步组中位疾病进展时间（14.1个月）长于序贯组（11.6个月）（P〈0.05）;两组中位生存期分别为21.3个月和19.6个月（P〉0.05）。不良反应为骨髓抑制、恶心呕吐、疲劳、放射性食管炎和放射性肺炎等。结论：培美曲塞联合放疗,同步放射治疗中晚期非小细胞肺癌较序贯放射治疗疗效好,不良反应可耐受,该方案治疗中晚期非小细胞肺癌值得进一步临床研究。Objective：To evaluate the efficacy and toxicity of pemetrexed combined with radiotherapy,concurrent chemoradiotherapy and sequential chemoradiotherapy in the treatment of advanced non -small cell lung cancer. Methods：Sixty -seven newly diagnosed patients of advanced non -small cell lung cancer received pemetrexed com-bined with radiotherapy,concurrent chemoradiotherapy and sequential chemoradiotherapy.Pemetrexed was adminis-tered with a dose of 500mg/m2 on day 1,per cycle（21 days）for 2 cycles.Radiation dose was 66Gy,2Gy/f,five times per week,and draining lymph node for a total dose of 58 ~60Gy.Results：Overall response rate was 76.5%（26 /34） in concurrent chemoradiotherapy group and 54.5%（18 /33）in sequential chemoradiotherapy group（P 〈0.05）.Me-dian time to progression was 14.1 months in concurrent group,which was higher than 11.6 months in sequential group with significant difference（P 〈0.05）.Median overall survival was 21.3 months and 19.6 months in concurrent group and sequential group（P 〉0.05）.Main toxicities were myelosuppression,nausea and vomit,fatigue,radiation esoph-agitis and radiation pneumonia.Conclusion：Pemetrexed combined with radiotherapy in the treatment of advanced non-small cell lung cancer,concurrent chemoradiotherapy is effective and tolerable,superior to sequential chemoradio-therapy.And it deserves further clinical research.

关 键 词：培美曲塞 同步放化疗 序贯放化疗 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]