摘要
目的：比较培美曲塞二钠和多西紫杉醇对一线化疗失败的晚期非小细胞肺癌（non—small cell lungcancer，NSCLC）患者的疗效与不良反应。方法：84例一线化疗失败或不能耐受的晚期NSCLC患者随机分为培美曲塞二钠组（44例）和多西紫杉醇组（40例），分别接受培美曲塞二钠500mg／m.治疗和多西紫杉醇75mg／m2治疗。入选患者均接受2～6个周期化疗。结果：所有患者参与评价，单用培美曲塞二钠组及单用多西紫杉醇组的有效率分别是13．6％（6／44）和10．0％（4／40）；疾病控制率分别是54．5％（24／44）和55．0％（22／40），两组的差异均无统计学意义，X^2=0．002，P值分别为0．741和0．967。单用培美曲塞二钠组和多西紫杉醇组患者的中位生存时间分别为8．2和8．1个月，1年生存率分别为27．3％和25．0％，两组的差异均无统计学意义，P值分别为0．258和0．580。两组的不良反应均为骨髓抑制、恶心、呕吐、乏力及脱发。培美曲塞二钠组发生中性粒细胞减少的概率明显低于多西紫杉醇组，Ⅰ～Ⅱ度分别为31．8％（14／44）和65．0％（26／40），X^2=9．249，P=0．002；Ⅲ～Ⅳ度分别为4．5％（2／44）和30．0％（12／40），X^2==9．775，P=0．002。结论：对于一线化疗失败或不能耐受的晚期NSCLC患者，分别使用培美曲塞二钠和多西紫杉醇进行化疗，疗效相似，但使用培关曲塞二钠化疗的不良反应更低，值得临床推广使用。
OBJECTIVE： To compare the efficacy and adverse reactions of pemetrexed and docetaxel in advanced non-small cell lung cancer （NSCLC） previously treated with first-line chemotherapy. METHODS： Totally 84 advanced NSCLC cases, who had failed or not tolerated with first-line chemotherapy, were randomly divided into pemetrexed group and docetaxel group, 44 patients received the treatment of pemetrexed 500 mg/m2 and 40 patients received docetaxel 75 mg/m2. All patients received 2-6 cycles chemotherapy. RESULTS： All cases were evaluated, the effective rate was 13.6% （6/44） vs 10.0%（4/40）, and disease control rate was 54.5% （24/44） vs 55.0%（22/40） in pemetrexed and docetaxel groups respectively. There was no significant difference between two groups（X^2 = 0. 002, and P values were 0. 741 and 0. 967）. The median survival time was 8.2 vs 8.1 months in pemetrexed and docetaxel groups respectively. The 1-year survival rates in pemetrexed and docetaxel groups were 27.3% and 25.0% respectively, and there was no significant difference between two groups （P values were 0. 258 and 0. 580）. The principal adverse reactions included myelosuppression, nausea, vomiting, fatigue and alopecia. Pa- tients receiving pemetrexed had less neutropenia Ⅰ--Ⅱ degree： 31.8%（14/44） vs 65.0%（26/40）, X^2=9.249,P--0.002; Ⅲ-Ⅳ degree： 4.5%（2/44） vs 30.0%（12/40）, X^2 = 9. 775 , P： 0. 002] compared with patients receiving docetaxel. CONCLUSIONS： The efficacy of the single-agent therapy of pemetrexed or doeetaxel is similar in the failed first-line chemotherapy in the advanced NSCLC, and pemetrexed has significantly fewer adverse reactions. So pemetrexed is worth popularizing clinically.
出处
《中华肿瘤防治杂志》
CAS
2011年第1期57-59,共3页
Chinese Journal of Cancer Prevention and Treatment
关键词
癌
非小细胞肺/药物疗法
谷氨酸盐类
紫杉酚
抗肿瘤药
carcinoma, non-small cell lung/drug therapy
glutamates
paclitaxel
antineoplastic agent
