EGFR-TKIs和培美曲塞序贯联合治疗与单药治疗EGFR-TKIs后缓慢进展晚期肺腺癌的疗效比较  

Comparison between EGFR-TKIs Sequential Pemetrexed and TKIs Orpemetrexed Alone in the Treatment of Advanced Lung Adenocarcinoma with Slow Progression after EGFR-TKIs Therapy

作　　者：汤志谋[1] 童波[1] 王凌[1] TANG Zhimou;TONG Bo;WANG Ling(The People's Hospital of Jiangxi,Nanchang,330006)

机构地区：[1]江西省人民医院

出　　处：《实用癌症杂志》2019年第12期1987-1990,2000,共5页The Practical Journal of Cancer

摘　　要：目的探讨表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)与化疗药物培美曲塞序贯联合对比单药TKIs及单药培美曲塞治疗EGFR-TKIs后缓慢进展的晚期肺腺癌的临床疗效。方法EGFR突变阳性的患者一线TKIs治疗后缓慢进展,共90例,二线治疗根据方案分为A组(单药培美曲塞组)、B组(继续单药TKIs组)、C组(TKIs与培美曲塞序贯组),各组30例。每接受2个周期治疗后评价临床疗效和不良反应。最后比较患者的无进展生存时间PFS和总生存时间OS。结果90例患者均可评价临床疗效,三组完全缓解率均为0,但C组的客观有效率(46.67%)及疾病控制率(86.67%)明显高于A组和B组。三组无进展生存时间和总生存时间无明显差异。三组无严重不良反应,均能耐受。结论对于TKIs治疗后缓慢进展的晚期肺腺癌患者,TKIs序贯培美曲塞治疗,对比单药培美曲塞或继续TKIs单药治疗,短期内有临床缓解优势,但无生存获益。Objective To observe the clinical effectof EGFR-TKIs sequential pemetrexed contrast to TKIs orpemetrexed alone in the treatment of advanced lung adenocarcinoma with slow progression after EGFR-TKIs therapy.Methods 90 cases of patients with EGFR mutation slow progress after the first-line treatment of TKIs,divided into group A(pemetrexed alone),group B(TKIs alone)and group C(EGFR-TKIs sequential pemetrexed)according to the second-line treatments,30 cases in each group.To evaluate clinical efficacy and adverse reactions after 2 cycle.And compare the PFS and OS of the patients in the end.Results 90 cases of patients were able to evaluate the clinical efficacy,the CR of the 3 groups were all 0,but ORR(46.67%)and DCR(86.67%)in group C was significantly higher than group A and group B.There was no significantly difference in PFS and OS among different groups.No severe side effects was observed and allpatients can tolerate it.Conclusion To the patients of advanced lung adenocarcinoma with slow progression after EGFR-TKIs therapy,compare treatments of EGFR-TKIs sequentialpemetrexed with TKIs orpemetrexed alone,there are short-term clinical benefit,but no survival benefit.

关 键 词：晚期肺腺癌 表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs) 培美曲塞 

分 类 号：R734.2[医药卫生—肿瘤]