摘要
目的:探讨培美曲塞联合铂类一线治疗晚期肺腺癌的疗效及安全性,分析其临床特点。方法:回顾性分析2011年2月至2017年8月在中国医学科学院肿瘤医院接受培美曲塞为基础方案化疗的Ⅲb/Ⅳ期肺腺癌患者450例的病历资料。根据一线化疗后是否进行维持治疗分成2组。分析其临床特点、无进展生存期(progression free survival,PFS)、疗效以及不良反应。结果:客观缓解率为33.6%,疾病控制率为87.6%,中位PFS为5.83个月。其中维持治疗组PFS为9.92个月,较非维持治疗组的4.60个月更长(P<0.001)。表皮生长因子受体突变阳性、功能状态评分(PS)=0分、化疗周期数在4个及以上,以及接受维持治疗是影响患者预后的保护性因素。化疗药物的主要不良反应包括血液学毒性、胃肠道反应、肝功能异常及乏力,但≥3级的不良反应发生率较低。结论:培美曲塞联合铂类一线治疗晚期肺腺癌安全有效,培美曲塞维持治疗有更高的生存获益。
Objective To evaluate the efficacy and safety of pemetrexed combined with platinum first-line therapy for advanced lung adenocarcinoma,as well as the clinical factors influencing outcomes.Methods We retrospectively evaluated the data from 450 pemetrexed-treated patients with stage Ⅲb/Ⅳ lung adenocarcinoma in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from February 2011 to August 2017. Patients were divided into 2 groups according to the presence of maintenance therapy after the first-line chemotherapy. The clinical features,progression free survival （PFS）,efficacy,and adverse reactions were analyzed.Results The overall median PFS was 5.83 mon. The maintenance treatment group had longer PFS 9.92 mon than the non-maintenance treatment group 4.60 mon after the first line chemotherapy （ P〈0.001）. The objective remission rate and disease control rate was 33.6% and 87.6%,respectively. It showed that positive mutation of epidermal growth factor receptor （EGFR）,PS=0,exposure more than 4 cycle,and the addition of maintenance treatment were the positive prognostic factors for survival. The main adverse drug reactions（ADR）of the patients were hematological toxicity,gastrointestinal reaction,abnormal and asthenia of liver function. However,the incidence of ADR≥3 was low.Conclusion First-line therapy with pemetrexed combined with platinum is safe and effective for advanced lung adenocarcinoma,and pemetrexed maintenance therapy has a better survival benefit.
作者
吉雪
胡兴胜
朱以香
刘雨桃
林琳
邢镨元
郝学志
王燕
李峻岭
JI Xue;HU Xing-sheng;ZHU Yi-xiang;LIU Yu-tao;LIN Lin;XIN Pu-yuan;HAO Xue-zhi;WANG Yan;LI Jun-ling(Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《临床药物治疗杂志》
2018年第7期41-45,共5页
Clinical Medication Journal
基金
中国老年学会老年肿瘤专业委员会科研课题(课题编号:CGOS-06-2016-1-1-00100)
关键词
培美曲塞
肺腺癌
晚期
维持治疗
pemetrexed
lung adenocarcinoma
advanced stage
maintenance therapy
