原TKI联合培美曲塞治疗晚期非小细胞肺癌EGFR-TKI获得性耐药患者的临床研究  

Clinical Observation of Efficacy and Safety of the Original EGFR-TKI Combined with Pemetrexed in the Treatment of EGFR-TKI Acquired Resistant Non-small Cell Lung Cancer

作　　者：叶永青 韩军 YE Yongqing;HAN Jun.(Lu＇an People＇s Hospital,Lu＇an,23700)

机构地区：[1]安徽医科大学附属六安医院(六安市人民医院),237005

出　　处：《实用癌症杂志》2018年第10期1655-1658,共4页The Practical Journal of Cancer

摘　　要：目的探究原TKI联合培美曲塞治疗晚期非小细胞肺癌EGFR-TKI获得性耐药患者的临床疗效及安全性。方法选取晚期非小细胞肺癌EGFR-TKI获得性耐药患者65例,随机分为单纯组33例和联合组32例,单纯组给予培美曲塞治疗,联合组在单纯组基础上联用原TKI治疗。观察2组患者治疗后临床疗效和不良反应。结果联合组RR为37. 50%,与单纯组的27. 27%相比,差异无统计学意义(P> 0. 05)。联合组DCR为81. 25%,与单纯组的60. 61%相比,差异具有统计学意义(P <0. 05)。联合组中位PFS为7. 8个月,单纯组为5. 9个月,联合组PFS显著长于单纯组,差异具有统计学意义(P <0. 05)。联合组中位OS为10. 2个月,单纯组为8. 9个月,2组OS差异无统计学意义(P>0. 05)。联合组白细胞减少发生与单纯组相比,差异具有统计学意义(P <0. 05)。2组不良反应均集中在Ⅰ～Ⅱ级,患者均可耐受。结论晚期NSCLC患者出现EGFR-TKI获得性耐药后,采用原TKI联合培美曲塞治疗较单用培美曲塞治疗DCR和PFS收益更加明显,临床疗效较好,不良反应可耐受。Objective To investigate the clinical efficacy and safety of the original EGFR-TKI combined with pemetrexed in the treatment of EGFR-TKI acquired resistant non-small cell lung cancer（NSCLC）. Methods 65 advanced NSCLC patients with EGFR-TKI acquired resistance were enrolled and randomly divided into single group of 33 cases and combination group of 32 cases.Single group was given pemetrexed while combination group was given the original TKI on the basis of single group.The clinical efficacy and adversed reactions were observed. Results The ORR in combination group was 37.50%,which showed no significant difference compared with that of 27.27% in single group（ P〉0.05）.The DCR in combination group was 81.25 %,which showed significant difference compared with that of 60.61% in single group（ P〈0.05）.The median PFS in combination group was 7.8 mo while that in single group was 5.9 mo.PFS of combination group was higher than that of single group,the difference was statistically significant（ P〈0.05）.The median OS in combination group was 10.2 mo while that of single group was 8.9 mo.There was no statistically significant difference between the OS of the 2 groups（ P〉0.05）.There was a statistically significant difference in the incidence of leukopenia between combination group and single group（ P〈0.05）.Adverse reactions of the 2 groups focused on the Ⅰ and Ⅱ level and the patient could be tolerated. Conclusion The benefit of DCR and PFS of the original EGFR-TKI combined with pemetrexed in the treatment of advanced NSCLC patients with EGFR-TKI acquired resistance is significantly more than those of pemetrexed alone and its clinical efficacy is good and the adverse reaction is tolerable.

关 键 词：EGFR-TKI获得性耐药 晚期非小细胞肺癌 培美曲塞 联合治疗 

分 类 号：R734.2[医药卫生—肿瘤]