培美曲塞与厄洛替尼维持治疗晚期非小细胞肺癌的临床研究被引量：18

Pemetrexed/Erlotinib Maintenance Therapies in Advanced Non-small Cell Lung Cancer

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摘要目的比较培美曲塞与厄洛替尼维持治疗晚期非小细胞肺癌的疗效、不良反应及生存期,探讨晚期非小细胞肺癌的合理治疗。方法选取我院2008年10月—2009年12月收治的52例晚期非小细胞肺癌患者,将其随机分为3组:培美曲塞组患者化疗前7 d开始给予补充叶酸、维生素B12,用药前1 d晚上及用药当天早、晚均给予地塞米松片5 mg,口服;培美曲塞500 mg/m2静脉滴注,同时给予对症支持治疗,21 d为1个周期。厄洛替尼组患者给予厄洛替尼150 mg/d,餐后2 h口服,同时给予对症支持治疗。支持治疗组患者仅给予对症支持治疗。中位无进展生存时间(PFS)作为观察终点,并观察不良反应发生情况。结果培美曲塞组、厄洛替尼组、支持治疗组PFS分别为7.9、6.2、3.2个月,3组患者中位PFS比较,差异有统计学意义(P<0.05)。培美曲塞组主要不良反应包括:骨髓抑制和胃肠道反应,停药对症治疗后缓解。厄洛替尼组最常见的不良反应是皮疹和腹泻,均为轻度反应,给予对症治疗后缓解。培美曲塞组与厄洛替尼组不良反应发生率比较差异有统计学意义(P<0.05)。结论培美曲塞与厄洛替尼维持治疗晚期非小细胞肺癌安全有效,能显著延长患者的PFS,且不良反应轻。 Objective To evaluate the clinical efficacy,toxicity and the median progression-free survival（PFS） of pemetrexed or Erlotinib in maintenance therapy of advanced non-small cell lung cancer（NSCLC）. Methods Fifty-two advanced NSCLC patients admitted to our hospital from October 2008 to December 2009 were divided randomly into groups A,B,C.Group A were given folic acid and vitamin B12 7 days before chemotherapy,oral dexamethasone tablets（5 mg） in the evening before chemotherapy,in the very morning and evening of chemotherapy day,and then pemetrexed,iv,500 mg/m2,simultaneously symptomatic support treatment,21 d as a cycle.Group B given erlotinib,150 mg/d,2 h postprandial oral administration and meanwhile support treatment.Group C given only support treatment.Taking median PFS as end point,side effects were observed. Results PFSs of groups A,B,C were 7.9,6.2,3.2 months,respectively,there was significant difference in median PFS（P0.05）.The side effects of group A included bone marrow suppression and gastrointestinal reactions,which relieved after drug withdrawal,symptomatic support therapy.Group B had such milder reactions as rash and diarrhea,relieving after symptomatic therapy.There was significant difference in side effect occurrence between 2 groups（P0.05）. Conclusion Pemetrexed and erlotinib,safe and effective in maintenance therapy of acvanced NSCLC,can prolong PFS with milder side effects.

作者毋永娟崔荣华云旗杨燕霞刘丽萍谭亚琴张文慧袁海清刘伟东

机构地区内蒙古自治区包头市肿瘤医院肿瘤内科一病区

出处《中国全科医学》 CAS CSCD 北大核心 2011年第9期966-968,共3页 Chinese General Practice

关键词癌非小细胞肺培美曲塞厄洛替尼抗肿瘤联合化疗方案治疗结果 Carcinoma non-small-cell lung Pemetrexed Erlotinib Antineoplastic combined chemotherapy protocols Treatment outcome

分类号 R734.2 [医药卫生—肿瘤]

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