培美曲塞或多西他赛联合奈达铂二线治疗晚期非小细胞肺癌的临床观察

Clinical Study on Pemetrexed or Docetaxel Combined with Nedaplatin in Second-Line Treatment of Advanced Non-small Cell Lung Cancer

目的:探讨培美曲塞或多西他赛联合奈达铂二线治疗晚期非小细胞肺癌的临床疗效和安全性。方法:选取2011年10月至2015年4月就诊的晚期非小细胞肺癌患者58例进行开放性观察研究,按就诊顺序分为培美曲塞与奈达铂联合化疗组(A组)、多西他赛与奈达铂联合化疗组(B组),每组29例。比较两组患者的客观缓解率、疾病控制率、中位生存期、无进展生存期及不良反应发生情况的差异。结果:A、B组患者的客观缓解率分别为17.2%(5/29)、13.8%(4/29),疾病控制率分别为55.2%(16/29)、48.3%(14/29),差异均无统计学意义(P>0.05);A、B组患者的中位生存期分别为7.8、8.7个月,无进展生存期分别为4.0、3.3个月,差异均无统计学意义(P>0.05);不良反应主要为血液毒性、胃肠道反应等,两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:对于晚期非小细胞肺癌一线化疗失败的患者,采用培美曲塞或多西他赛联合奈达铂二线治疗仍可获得一定的治疗效果,两种方案的效果相近,能有效改善患者的生活质量且安全性较好。

OBJECTIVE:To probe into the clinical efficacy and safety of pemetrexed or docetaxel combined with nedaplatin in second-line treatment of advanced non-small cell lung cancer (NSCLC).METHODS:58 patients with advanced NSCLC admitted from Oct.2011 to Apr.2015 were selected for open research,and were divided into group of pemetrexed combined with nedaplatin (group A) and group of docetaxel combined with nedaplatin (group B) according to the order of treatment,with 29 cases in each group.Differences in objective remission rates,control rates of diseases,median survival time,progression free survival and incidences of adverse drug reactions between two groups were compared.RESULTS:The objective remission rates of group A and group B were respectively 17.2%(5/29) and 13.8%(4/29),with the control rates of diseases were respectively 55.2%(16/29) and 48.3%(14/29),the differences had no statistical significance ( P >0.05);the median survival time of group A and group B were respectively 7.8 months and 8.7 months,with the progression free survival were respectively 4.0 months and 3.3 months,the differences had no statistical significance ( P >0.05);the adverse drug reactions were mainly hematotoxicity and gastrointestinal reaction,there was no statistical significance in the difference of incidences of adverse drug reactions ( P >0.05).CONCLUSIONS:For the patients who failed in the first-line chemotherapy for advanced non-small cell lung cancer,pemetrexed or docetaxel combined with nedaplatin can still achieve certain therapeutic effects.The two regimens have similar efficacy and can effectively improve patients’ quality of life,with good safety.