培美曲塞+卡铂二线治疗方案对EGFR-TKIs一线治疗失败的NSCLC患者疗效及生存质量的影响  

Effect of pemetrexed plus carboplatin as second-line therapy on the efficacy and quality of life of NSCLC patients with failure of EGFR TKIs first-line therapy

作　　者：谢晓东[1] 姜海英[1] 吕姣[1] 朱梅[1] 李倩[1] 邱朝阳 Xie Xiaodong;Jiang Haiying;Lyu Jiao;Zhu Mei;Li Qian;Qiu Chaoyang(Department of Oncology,Xuzhou Cancer Hospital,Xuzhou 221005,China)

机构地区：[1]江苏省徐州市肿瘤医院肿瘤内科,徐州221005

出　　处：《广西医科大学学报》2021年第7期1412-1416,共5页Journal of Guangxi Medical University

基　　金：国家科技支撑计划子课题资助项目(No.2013BAI106B04H008)。

摘　　要：目的:研究培美曲塞+卡铂二线治疗方案在治疗表皮生长因子受体络氨酸激酶抑制剂(EGFR-TKIs)一线治疗失败的非小细胞肺癌(NSCLC)中的疗效及生存质量的影响。方法:回顾性分析2016年5月至2018年5月江苏省徐州市肿瘤医院收治的80例EGFR-TKIs一线治疗失败的NSCLC患者,按随机数字表法将患者分为观察组和对照组,每组40例,观察组患者进行培美曲塞+卡铂(AP)治疗,对照组患者行多西他赛+卡铂(DP)治疗,比较两组治疗后生活质量与治疗效果,并绘制生存曲线,评价其无疾病进展生存时间(PFS)与总生存时间(OS)。结果:治疗3个月后评估两组生活质量,观察组患者FACT-L量表中身体状况及肺功能状况得分高于对照组(P<0.05);随访时间2~12个月,中位随访时间5个月,截止随访结束时,共63例患者死亡,两组均无患者获得完全缓解,但观察组疾病进展发生率低于对照组,客观缓解率高于对照组(P<0.05);绘制Kaplan-Meier曲线图发现,观察组中位PFS(mPFS)为5.5个月,对照组mPFS为3.5个月,两组mPFS差异显著(P<0.05);观察组OS为9.1个月,对照组OS为7.2个月,两组OS差异显著(P<0.05);对照组白细胞减少发生率显著高于观察组(P<0.05),其他不良反应比较,差异无统计学意义(P>0.05)。结论:AP在治疗EGFR-TKIs耐药性NSCLC患者中具有较好的应用价值,相比于DP方案,其能有效延长患者mPFS、OS。Objective:To study the efficacy of pemetrexed plus carboplatin as second-line therapy in patients with non-small cell lung cancer(NSCLC)who failed to receive first-line treatment of epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)and its impact on patients’life quality.Methods:Retrospective analysis was performed on 80 NSCLC patients with failure of first-line treatment of EGFR-TKIS inour hospital from May 2016 to May 2018.The patients were randomly divided into an observation group and a control group,with 40 cases in each group.Patients in the observation group were treated with pemetrexed+carboplatin(AP),while patients in the control group were treated with docetaxel+carboplatin(DP).The life quality of patients and therapeutic effect were compared.The survival curve was drawn to evaluate the progression free survival(PFS)and overall survival(OS)time.Results:After 3 months of treatment,the scores of physical condition and lung function in FACT-L scale of the observation group were significantly higher than those ofthe control group(P<0.05).The follow-up time was 2-12 months,and the median follow-up time was 5 months.By the end of the follow-up,63 patients died,and no patients in the two groups achieved complete remission.However,the incidence of disease progression in the observation group was significantly lower than that in the control group(P<0.05),and the objective remission rate in the observation group was significantly higher than that in the control group(P<0.05).The Kaplan Meier curve showed that the medianPFS(mPFS)of the observation group was 5.5 months,and that of the control group was 3.5 months(P<0.05).The OS was 9.1 months and 7.2 months in the observation group and control group,respectively(P<0.05).The incidence of leucopenia in the observation group was significantly lower than that in the control group(P<0.05),and there were no significant differences in other adverse reactions between the two groups(P>0.05).Conclusion:AP has a good application value in the treatment of

关 键 词：培美曲塞+卡铂 多西他赛+卡铂 EGFR-TKIs失败 NSCLC 生存质量 

分 类 号：R734.2[医药卫生—肿瘤]