放疗联合培美曲塞或多西他赛治疗非小细胞肺癌靶向治疗失败合并脑转移患者的疗效对比研究

Comparative Study of Radiotherapy Combined with Pemetrexed or Docetaxel in NSCLC Patients with Brain Metastases

目的比较放疗联合培美曲塞或多西他赛在非小细胞肺癌(NSCLC)靶向治疗失败合并脑转移患者中的临床疗效及安全性。方法选取于2012年4月—2015年10月南阳医学高等专科学校第一附属医院治疗的NSCLC靶向治疗失败合并脑转移患者共77例,根据化疗方案分为培美曲塞组(39例)与多西他赛组(38例)。培美曲塞组给予放疗联合培美曲塞治疗,多西他赛组给予放疗联合多西他赛治疗。比较两组患者的临床疗效、毒副作用及预后情况。结果两组有效率(RR)比较,差异无统计学意义(P=0.347);培美曲塞组疾病控制率(DCR)高于多西他赛组(P=0.041)。培美曲塞组的贫血、血小板减少、恶心呕吐、食欲减退发生率低于多西他赛组(P<0.05)。培美曲塞组的中位PFS(6.6个月)长于多西他赛组的中位PFS(4.5个月)(P<0.05);培美曲塞组的中位OS为10.4个月,多西他赛组患者的中位OS为11.2个月,两组比较差异无统计学意义(P>0.05)。结论放疗联合培美曲塞治疗NSCLC靶向治疗失败合并脑转移患者的效果优于放疗联合多西他赛,毒副作用较小,能提高患者的疾病控制率、延长无进展生存期。

Objective To compare the clinical curative effect and safety of radiotherapy combined pemetrexed anddocetaxel on the treatment of NSCLC patients with failure of targeted therapy combined brain transfer. Methods From April2012 to October 2015,77 NSCLC patients combined brain transfer with failure of targeted treatment were includedfrom the First Affiliated Hospital of Nanyang Medical College,which divided into the pemetrexed group( 39 cases) and the docetaxel group( 38 cases). Pemetrexed group was given radiotherapy combined with pemetrexed,and docetaxel was given radiotherapy combined with docetaxel. The clinical efficacy,side effects and prognosis of the two groups of patients were compared. Results The two groups' RR comparison difference has no statistical significance( P = 0. 347),the pemetrexed group of DCR was significantly higher than the docetaxel group( P = 0. 041), the pemetrexed group' s anemia, thrombocytopenia, nausea,vomiting and anorexia ratio was significantly lower than the docetaxel group( P < 0. 05),the pemetrexed group's median PFS was6. 6 months,the docetaxel group's median PFS was 4. 5 months,with significant difference( P < 0. 05); the Median OS of the two group have no statistical significance( P > 0. 05). Conclusion Radiotherapy combined with pemetrexed in the treatment of NSCLC target therapy failure combined with brain metastases in patients with better than docetaxel,less toxic side effects,can improve the patient's disease control rate,prolong the progression-free survival.