背景与目的,目前肺癌挽救性治疗尚无标准方案.本研究旨在比较培美曲赛单药与培美曲赛联合奥沙利铂挽救性治疗Ⅳ期肺腺癌患者的疗效及安全性,为联合化疗提供依据.方法,2009年1月-2011年2月共83例体能状态评分(performance status,PS)为0分-2分的Ⅳ期肺腺癌患者分别接受培美曲赛(单药组47例)和培美曲赛联合奥沙利铂(联合组36例)挽救性治疗,观察两组近期疗效和毒性反应并进行比较.结果,81例患者纳人最终分析.单药组与联合组中位无进展生存时间(progression-free survival,PFS)分别为3.6个月vs4.1个月(P=0.268),客观反应率(objective response rate,ORR)和疾病控制率(disease control rate,DCR)分别为6.5% vs 20%(P=0.092)和56.5% vs65.7%(P=0.493).单药组与联合组血液毒性及胃肠道反应发生率分别为33.9% vs 47.2% (P=0.460)和21.2% vs 25.0%(P=0.213).结论,培美曲赛联合奥沙利铂挽救性治疗PS评分较好的Ⅳ期肺腺癌患者耐受性良好,与培美曲赛单药相比显示出较高的缓解率,但未明显增加患者的PFS.%Background and objective At present, there is no standard salvage treatment strategies for lung cancer. The aim of this study is to compare the efficacies and safeties of pemetrexed alone with pemetrexed combined with oxaliplatin as salvage therapy in stage IV lung adenocarcinoma to provide evidences for combination therapy. Methods From January 2009 to February 2011, 83 patients with stage IV lung adenocarcinoma received pemetrexed alone (single agent arm, ?=47) or pemetrexed combined with oxaliplatin (combination arm, n=36) as salvage therapy. All 83 patients had performance status (PS) scores of 0-2. Results Eighty-one patients were included in the final analysis. The median progression-free survival (PFS) in the single agent arm was 3.6 months versus 4.1 months in the combination arm (P=0.268). The objective response rate (ORR) was 6.5% versus 20% (P=0.092), and the disease control rate (DCR) was 56.5% versus 65.7% (P=0.493), respectively. The response rates of the hematological and gastrointestinal toxicities in the single agent and combination arms were 33.9% versus 47.2% (P=0.460) and 21.2% versus 25.0% (P=0.213), respectively. Conclusion For salvage therapy, pemetrexed combined with oxaliplatin is tolerable in stage IV lung adenocarcinoma patients with good PS scores. Compared with pemetrexed alone, pemetrexed combined with oxaliplatin therapy showed higher response rate, but did not significantly prolong the PFS.
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