吉非替尼对比培美曲塞二线治疗晚期非小细胞肺癌的临床研究  

A randomized clinical study of gefitinib and pemetrexed as second line therapy for advanced non-small cell lung cancer

作　　者：张定国[1] 阮秀丽[2] 

机构地区：[1]湖北省红安县人民医院肿瘤科,湖北黄冈4384000 [2]湖北省红安县人民医院内科,湖北黄冈4384000

出　　处：《癌症进展》2016年第1期78-80,86,共4页Oncology Progress

摘　　要：目的观察吉非替尼与培美曲塞二线治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)情况,比较二者对晚期NSCLC患者的治疗效果、安全性的影响。方法将一线化疗治疗失败后的105例晚期NSCLC患者,随机分为吉非替尼组和培美曲塞组,分别接受吉非替尼与培美曲塞二线治疗,比较两组患者的治疗效果和安全性。结果近期疗效比较结果显示,吉非替尼组和培美曲塞组客观有效率(ORR)分别为24.0%和29.1%(P=0.987),疾病控制率(DCR)分别为64.0%和70.9%(P=0.776);吉非替尼组和培美曲塞组中位无进展生存时间(PFS)分别为5.2个月和4.1个月(P=0.026),中位总生存期(OS)分别为7.9个月和6.7个月(P=0.031),吉非替尼组PFS和OS均优于培美曲塞组。吉非替尼组的不良反应主要为非血液学毒性,培美曲塞组的主要不良反应为血液学毒性。结论吉非替尼及培美曲塞均可用于晚期NSCLC患者的二线治疗,疗效相当,但二者的不良反应各异,可根据患者的个体差异择优选用。Objective To observe the efficacy ofpemetrexed and gefitinib as second-line treatment in advanced non-small cell lung cancer （NSCLC）, and to compare the clinical effects and safety of the two therapies. Method A total of 105 cases of advanced NSCLC patients with failed first-line chemotherapy were randomized into gefitinib group or pemetrexed group, receiving gefitinib or pemetrexed as the second-line treatment, and the outcomes and safety were compared. Result Short-term efficacy comparison showed that gefitinib group and pemetrexed group had objective response rates （ORR） of 24.0% and 29.1% （P = 0.987）, and disease control rate （DCR） were 64.0% and 70.9% （P = 0.776）, respectively; And the median progression free survival （PFS） was 5.2 months and 4.1 months （P=0.026）, while the median overall sur- vival （OS） was 7.9 months and 6.7 months（P=-0.031）, both were better in gefitinib group than in the pemetrexed group. As for adverse reactions, non-hematologic toxicities and hematologic toxicities were observed in gefinitib and pemetrexed group, respectively. Conclusion Both of the gefitinib and pemetrexed were applicable as the second-line treatment for patients with advanced NSCLC, with similar efficacy but varied adverse reactions, so the two therapies should be determined based on individual variability.

关 键 词：吉非替尼 培美曲塞 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]