培美曲塞维持治疗在晚期非小细胞肺癌中的疗效分析

Effect of pemetrexed maintenance therapy on treatment of patients with advanced non-small cell lung cancer

目的探讨不同的一线治疗方案对培美曲塞单药维持治疗疗效的影响。方法选取41例行培美曲塞联合顺铂(PC组)和29例吉西他滨联合顺铂(GC组)一线治疗的ⅢB/Ⅳ期非鳞状细胞NSCLC患者,疾病得到控制者进入培美曲塞维持治疗。结果在一线治疗中,PC组和GC组有效率(χ2=0.0442,P=0.8332)和疾病控制率(χ2=0.0049,P=0.9439)均无显著性差异。而在维持治疗阶段,2组的有效率(χ2=0.0601,P=0.8059)、疾病控制率(χ2=0.0045,P=0.9464)和无进展生存期(χ2=1.904,P=0.168)均亦无显著性差异,但PC组患者的总生存期显著长于GC组的[15.4月∶11.6月(χ2=5.243,P=0.022)]。结论不同的一线治疗方案对培美曲塞单药维持治疗的近期疗效无影响,但在远期疗效上有差异。

Objective To explore the influence of different first-line therapies on the therapeutic effect of pemetrexed maintenance therapy.Methods 41 patients withⅢ B orⅣ non-squamous non-small cell lung cancer（NSCLC） treated by pemetrexed combined with cisplatin（PC group） and 29 patients treated by gemcitabine combined with cisplatin（GC group） as first-line chemotherapy were collected, and patients with control of disease were treated with further pemetrexed maintenance therapy. Results There were no significant differences of the response rate（χ 2= 0.0442, P= 0.8332）and disease control rate（χ 2= 0.0049, P= 0.9439）between PC and GC groups. In the maintenance treatment period, there were no significant differences of the response rate（χ 2= 0.0601, P= 0.8059）, disease control rate（χ 2= 0.0045, P= 0.9464）and progressionfree survival（χ 2= 1.904, P= 0.168）between two groups, but the overall survival period in PC group was significantly longer than that in GC group（15.4 months︰11.6 months,χ 2= 5.243, P= 0.022）. Conclusion Different first-line therapies have no influence on the short-term effects of pemetrexed maintenance therapy, but affect the long-term effects.