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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例患者纳入最终分析。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%vs20%(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%vs47.2%(P=0.460)和21.2%vs25.0%(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 Currently, there is no standard plan for salvage treatment of lung cancer. This study was designed to compare the efficacy and safety of pemetrexed monotherapy with pemetrexed combined with oxaliplatin in the treatment of patients with stage IV adenocarcinoma of the lung and to provide a basis for combination chemotherapy. Methods From January 2009 to February 2011, 83 patients with stage IV lung adenocarcinoma with performance status (PS) score of 0-2 were enrolled in the study. Metoccyx combined with oxaliplatin (combined group of 36 cases) salvage treatment, the two groups observed the short-term efficacy and toxicity and compared. Results 81 patients were included in the final analysis. The median progression-free survival (PFS) was 3.6 months vs 4.1 months (P = 0.268), objective response rate (ORR) and disease control rate (disease control rate, DCR) were 6.5% vs20% (P = 0.092) and 56.5% vs65.7% (P = 0.493) respectively. The incidences of hematotoxicity and gastrointestinal reactions were 33.9% vs47.2% (P = 0.460) and 21.2% vs25.0% (P = 0.213) in the monotherapy group and the combination group, respectively. Conclusions Pemetrexed combined with oxaliplatin salvage therapy is well tolerated in patients with stage IV adenocarcinoma of stage IV lung cancer, which shows a higher response rate than pemetrexed monotherapy but does not significantly increase Patient’s PFS.