培美曲塞联合奥希替尼二线治疗EGFR T790M突变非小细胞肺癌脑转移的临床研究  

Clinical Study of Pemetrexed Combined with Osimertinib as Second-line Treatment for Brain Metastases of EGFR T790M Mutated Non-small Cell Lung Cancer

作　　者：赵双霞 Zhao Shuangxia(Xiaogan Dawu County People's Hospital,Xiaogan 432800,Hubei Province,China)

机构地区：[1]孝感市大悟县人民医院,湖北孝感432800

出　　处：《中外医药研究》2025年第10期67-69,72,共4页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析培美曲塞联合奥希替尼二线治疗EGFR T790M突变非小细胞肺癌脑转移的临床效果。方法:采用回顾性研究方法,选择2021年1月—2023年1月于孝感市大悟县人民医院就诊的64例一线治疗失败的EGFR T790M突变非小细胞肺癌脑转移患者,将其分为对照组(实施培美曲塞二线治疗)、试验组(在对照组基础上实施奥希替尼二线治疗),各32例。分析治疗效果。结果:试验组腹泻、皮疹、甲沟炎发生率高于对照组,骨髓抑制、乏力、恶心呕吐、转氨酶升高发生率低于对照组(P<0.05);两组口腔炎发生率比较,差异无统计学意义(P>0.05)。试验组治疗后癌胚抗原、神经烯醇化酶、血管内皮生长因子水平低于对照组(P<0.05)。试验组治疗后细胞角质蛋白19片段抗原21-1、基质金属蛋白酶-9水平低于对照组,脑部肿瘤直径短于对照组(P<0.05)。结论:对EGFR T790M突变非小细胞肺癌脑转移患者采取培美曲塞联合奥希替尼二线治疗具有较高的安全性,骨髓抑制、乏力、恶心呕吐、转氨酶升高发生率更低,可以有效缩小患者脑部肿瘤直径,改善血清肿瘤标志物、血管内皮生长因子及实验室指标水平。Objective:To analyze the clinical effect of pemetrexed combined with osimertinib as second-line treatment for brain metastases of EGFR T790M mutated non-small cell lung cancer.Methods:A retrospective study was conducted.Sixty-four patients with brain metastases from EGFR T790M mutant non-small cell lung cancer who failed first-line treatment and were treated at Xiaogan Dawu County People's Hospital from January 2021 to January 2023 were selected and divided into the control group(treated with pemetraxed as second-line treatment)and the experimental group(treated with osimertinib as second-line treatment on the basis of the control group),thirty-two cases each.The therapeutic effect was analyzed.Results:The incidences of diarrhea,rash and paronychia in the experimental group were higher than those in the control group,while the incidences of bone marrow suppression,fatigue,nausea and vomiting,and elevated transaminase were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of stomatitis between the two groups(P>0.05).After treatment,the levels of carcinoembryonic antigen,neural enolase and vascular endothelial growth factor in the experimental group were lower than those in the control group(P<0.05).After treatment,the levels of keratin 19 fragment antigen 21-1 and matrix metalloproteinase-9 in the experimental group were lower than those in the control group,and the diameter of brain tumors in the experimental group was shorter than that in the control group(P<0.05).Conclusion:For patients with brain metastases from EGFR T790M mutated non-small cell lung cancer,second-line treatment with pemetrexed combined with osimertinib has high safety.The incidences of bone marrow suppression,fatigue,nausea and vomiting,and elevated transaminase are lower.It can effectively reduce the diameter of brain tumors in patients and improve the levels of serum tumor markers,vascular endothelial growth factor and laboratory indicators.

关 键 词：EGFR T790M突变 非小细胞肺癌 脑转移 奥希替尼 培美曲塞 二线治疗 

分 类 号：R734.2[医药卫生—肿瘤]