培美曲塞单药继续维持化疗治疗晚期肺腺癌临床疗效观察

Clinical observation of pemetrexed monotherapy in the treatment of advanced lung adenocarcinoma

目的探讨培美曲塞单药继续维持化疗治疗晚期肺腺癌的临床疗效。方法选取自2018年4月至2019年10月北部战区总医院胸外科收治的46例晚期肺腺癌患者为研究对象。采用随机数字表法将患者分为A组(n=22)与B组(n=24)。所有患者均采用培美曲塞500 mg/m^2+顺铂75 mg/m^2化疗4个疗程。A组患者给予最佳支持治疗,B组患者给予单药培美曲塞500 mg/m^2继续维持化疗治疗。所有患者每4周进行1次随访。记录并比较两组患者的临床疗效、中位疾病进展时间(TTP)及不良反应发生情况。结果A组治疗的总有效率为54.5%(12/22),低于B组的83.3%(20/24),差异有统计学意义(P<0.05)。B组的中位TTP为12.3个月,显著长于A组的6.2个月,差异有统计学意义(P<0.05)。B组患者Ⅰ~Ⅱ级不良反应发生率为33.3%(8/24),显著高于A组的13.6%(3/22),差异有统计学意义(P<0.05)。A、B两组患者Ⅲ~Ⅳ级不良反应发生率分别为4.5%(1/22)、8.3%(2/24),差异无统计学意义(P>0.05)。结论晚期肺腺癌患者在接受培美曲塞+顺铂方案一线化疗后,采用培美曲塞单药继续维持治疗安全、有效。

Objective To investigate the clinical effect of pemetrexed monotherapy in the treatment of advanced lung adenocarcinoma.Methods A retrospective study was performed on 46 cases of patients with advanced lung adenocarcinoma who were admitted from April 2018 to October 2019.Patients were randomly divided into Group A(n=22)and Group B(n=24).All patients were treated with pemetrexed 500 mg/m^2+cisplatin 75 mg/m^2 for 4 courses of chemotherapy.Patients in Group A were given the best supportive treatment,while patients in Group B were given pemetrexed 500 mg/m^2 single drug to continue maintenance chemotherapy.All patients were followed up once every 4 weeks.Clinical efficacy,median disease progression time(TTP)and adverse reactions were recorded and compared between the two groups.Results The total effective rate of treatment in Group A was 54.5%(12/22),which was lower than 83.3%(20/24)in Group B,and the difference was statistically significant(P<0.05).The median TTP in Group B was 12.3 months,significantly longer than that in Group A(6.2 months),P<0.05.The incidence of adverse reactions of patients with GradeⅠ~Ⅱwas 33.3%(8/24),significantly higher than 13.6%(3/22)in Group A,P<0.05.The incidence of adverse reactions in Group A and Group B of patients with GradeⅢ~Ⅳincidence was 4.5%(1/22)and 8.3%(2/24),there was no statistically significant difference(P>0.05).Conclusion Patients with advanced lung adenocarcinoma receive first-line chemotherapy with pemetrexed+cisplatin,and continue to be treated safely and effectively with pemetrexed monotherapy.