Objective To compare the efficacy and toxicities of pemetrexed or docetaxel as the salvage chemotherapy in patients with retreatment of advanced non-small cell lung cancer ( NSCLC) after the failure of epidermal growth factor receptor-tyrosine ki-nase inhibitor (EGFR-TKI). Methods In this study, we retrospectively reviewed 120 cases with retreatment of advanced NSCLC patients in our hospital who were given pemetrexed (500mg/m2 d,) or docetaxel (75mg/m2 d,) as the salvage chemotherapy after the failure of EGFR-TKI. Twenty-one days was a cycle for the two regimens. Results The pemetrexed group was similar to the docetaxel group in objective response rate (13. 4% vs. 5. 3% ,P = 0. 307), the disease control rate {58. 5% vs. 42. 1 % ,P = 0. 093), the median progression-free survival (2. 83 months vs. 2. 10 mondis,P=0. 862),and the median overall survival (8. 40 months vs. 9. 10 months, P = 0. 527). The median PFS was longer in the patients whose disease could be controlled by EGFR-TKI and who had performance status (PS) ≤l(/P<0.05). The pemetrexed group was lower than the docetaxel group in 14 degree neutropenia inhibition (41.5% is. 65.8% , P = 0.013). The non-hematology toxicities did not have significantly differences between the two groups (P>0.05). Conclusion A part of patients with retreatment of advanced NSCLC after the failure of EGFR-TKI may still benefit from pemetrexed or docetaxel as the salvage chemotherapy. The efficacy between the two groups does not have significantly difference. The patients whose disease can be controlled by EGFR-TKI or who have PS≤1 are more likely to benefit from the salvage chemotherapy. Most of the pa-tients could accept the adverse reactions of the salvage chemotherapy.%目的 比较复治晚期非小细胞肺癌(NSCLC)表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)治疗失败后用培美曲塞或多西他赛挽救性化疗的疗效及毒副反应.方法 120例复治晚期NSCLC患者于EGFR-TKI治疗失败后分别接受培美曲塞(500mg/m2,d1)或多西他赛(75mg/m2,d1)的挽救性化疗,均21天为1周期.记录并比较两者的疗效和预后.结果 培美曲塞组和多西他赛组的有效率(RR)分别为13.4％和5.3％(P =0.307),疾病控制率(DCR)分别为58.5％和42.1％(P=0.093),中位无进展生存期(PFS)分别为2.83个月和2.10个月(P =0.862),中位总生存期(OS)分别为8.40个月和9.10个月(P =0.527).EGFR-TKI治疗有效和挽救性化疗前行为状态评分(PS)≤1者的中位PFS较长.培美曲塞组1～4级中性粒细胞减少的发生率低于多西他赛组,分别为41.5％和65.8％(P=0.013).在非血液学毒性方面两组差异均无统计学意义(P＞0.05).结论 复治晚期NSCLCTKI治疗失败后用培美曲塞或多西他赛挽救性化疗,部分患者仍可以获益,两组疗效相当,且大部分患者能够耐受化疗的毒副反应.对于EGFR-TKI治疗有效、挽救性化疗前PS评分较好的患者,有可能从挽救性化疗中获益更大.
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