培美曲塞联合奈达铂治疗晚期非鳞状 NSCLC 的疗效分析

摘要

Objective To evaluate the efficacy and safety of pemetrexed ( PEM) and nedaplatin ( NDP) as first-line and second-line chemotherapy for advanced non squamous non-small cell lung cancer .Methods 82 patients with non squamous non-small cell lung cancer who were treated with pemetrexed and nedaplatin were divided into 2 groups.Team A(36 cases) received chemotherapy as first-line treatment while team B (46 cases) received chemotherapy as seconed-line treatment.The response rate ( RR)、disease control rate ( DCR)、time to progression ( TTP)、1-year survival rate of the 2 groups were evlauated after at least 2 cycles,and adverse reactions were observed .Results Among the 82 cases,there were 1 CR (1.22%),17 PR (20.73%),25 SD (30.49%),and 39 PD (47.56%).The overall response rate was 21.95% (18/82),and DCR was 52.44%,mTTP was 10.3 months and 1-year survival rate was 76.59%.The effect of group A was better than that of the group B ,there was statistical difference .The adverse reactions were tolerable .Conclusion Pemetrexed and nedaplatin is effective first-line and second-line therapy for advanced non squamous non-small cell lung cancer ,it is worthy of clinical application .%目的：评价培美曲塞（pemetrexed，PEM）联合奈达铂（nedaplatin，NDP）方案一线和二线治疗晚期（Ⅲb和Ⅳ期）非鳞状非小细胞肺癌（ NSCLC）的疗效及安全性。方法采用培美曲塞联合奈达铂治疗82例晚期非鳞状NSCLC患者，分为A、B两组：A组36例患者，一线采用培美曲塞（ PEM ）联合奈达铂化疗； B组46例患者，为一线治疗进展后患者，方案同上。所有患者化疗至少2个周期后评价近期有效率（ RR）、疾病控制率（ DCR）、疾病进展时间（ TTP）、1年生存率；并观察患者的不良反应及耐受性。结果82例患者中完全缓解1例（1．22％），部分缓解17例（20．73％），稳定25例（30．49％），进展39例（47．56％），总有效率为21．95％，疾病控制率52．44％，中位疾病进展时间（mTTP）为10．3个月，1年生存率为76．59％。 A组有效率高于B组，差异有统计学意义。不良反应可耐受。结论培美曲塞联合奈达铂方案是治疗晚期非鳞癌NSCLC安全有效的一线和二线化疗方案之一，可推广使用。