Clinical Observation and Prognostic Analysis of Pemetrexed plus Platinum as First-line Treatment in Patients with Advanced Non-small Cell Lung Cancer

摘要

Objective: To determine clinical efficacy, safety and prognostic factors of pemetrexed plus platinum as firstlinetreatment in patients with advanced non-small cell lung cancer (NSCLC). Materials and Methods: Clinicalcharacteristics, short-term efficacy, survival and adverse reactions of 47 advanced non-squamous NSCLCpatients who had received pemetrexed plus platinum as first-line treatment in Shanghai Pulmonary Hospitalfrom January 2009 to June 2011 were retrospectively analyzed. The Chi-squared test was applied to statisticallyanalyze the overall response rate (ORR), disease control rate (DCR) and toxicity reactions in both groups, whilesurvival data wereanalyzed by Kaplan-Meier and logrank methods, and the COX proportional hazards modelwas adopted for a series of multi-factor analyses. Results: Only two patients were lost to follow-up. The ORR,DCR, medium progression-free survival time (PFS) and medium overall survival (OS) were 31.9%, 74.5%, 5months and 15.2 months, while 1- and 2-year survival rates were 63.8% (30/47) and 19.2% (9/47), respectively.Single-factor analysis showed that tumor pathological patterns and efficacy were in association with mediumPFS (P<0.05), whereas tumor pathological patterns, smoking history and efficacy were closely connectedwith medium OS (P<0.05). Multi-factor analyses demonstrated that pathological patterns and efficacy wereindependent factors influencing OS (P<0.05). The rate of toxicity reactions in degree Ⅲ/Ⅳ was low, includinghematologic toxicity marked by decline in white blood cell count and decrease in the platelet count (PLT), andnon-hematologic toxicity manifested by gastrointestinal reactions, such as nausea and vomiting. Conclusions:Pemetrexed plus platinum as first-line treatment has excellent efficacy and slight adverse reactions with favorabledrug-tolerance in patients with advanced non-squamous NSCLC.