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目的:探讨AP(培美曲塞+顺铂)和TP(多西紫杉醇+顺铂)方案对EGFR-TKIs耐药的晚期非小细胞肺癌(NSCLC)患者的疗效。方法:回顾性分析2009年2月至2010年3月广州医科大学附属第一医院收治的232例EGFR-TKIs耐药的晚期NSCLC患者的临床资料,根据化疗方案不同分为AP组(培美曲塞+顺铂)和TP组(多西紫杉醇+顺铂),每组各116例。根据RECIST标准评价近期疗效(RR、DCR)、总生存期(OS),无进展生存期(PFS)。结果:TP组和AP组有效率、自靶向药物进展后总生存期分别为34.5%和24.1%、12.4个月和12.0个月,两组比较,差异无统计学意义(P>0.05)。TP组和AP组PFS分别为8.0个月和6.2个月,两组比较,差异有统计学差异(P<0.01)。AP组中不吸烟与吸烟患者的总生存期、PFS分别为12.0和9.0个月、6.5和5.6个月,两者比较,差异有统计学意义(P<0.01)。两组吸烟与不吸烟患者疾病控制率比较,差异无统计学意义(P>0.05)。TP组中不吸烟与吸烟患者的总生存期分别为14和8.8个月,两者比较,差异无统计学意义(P=0.725);TP组中不吸烟与吸烟患者的PFS分别为8.0和6.0个月,两者比较,差异有统计学意义(P<0.01)。结论:AP和TP方案对EGFR-TKI靶向治疗耐药进展的晚期NSCLC患者疗效相似;吸烟者疗效较不吸烟者差。
Objective: To investigate the efficacy of AP (pemetrexed + cisplatin) and TP (docetaxel + cisplatin) regimens in patients with advanced non-small cell lung cancer (NSCLC) resistant to EGFR-TKIs. Methods: The clinical data of 232 advanced NSCLC patients with EGFR-TKIs resistance admitted to the First Affiliated Hospital of Guangzhou Medical University from February 2009 to March 2010 were retrospectively analyzed. According to the different chemotherapy regimens, they were divided into AP group (Pemetrexed Cisplatin + cisplatin) and TP group (docetaxel + cisplatin), each group of 116 cases. The RECIST criteria were used to evaluate the short-term efficacy (RR, DCR), overall survival (OS), progression-free survival (PFS). Results: The effective rates of TP group and AP group were 34.5% and 24.1%, 12.4 and 12.0 months, respectively, with no significant difference between the two groups (P> 0.05). The PFS of TP group and AP group were 8.0 months and 6.2 months, respectively. There was significant difference between the two groups (P <0.01). The overall survival of non-smoking and smoking patients in AP group were 12.0 and 9.0 months, 6.5 and 5.6 months, respectively, with significant differences (P <0.01). Two groups of smoking and non-smoking patients disease control rates, the difference was not statistically significant (P> 0.05). The overall survival of non-smoking and smoking patients in TP group were 14 and 8.8 months, respectively, with no significant difference (P = 0.725). The PFS of TP and non-smoking patients in TP group were 8.0 and 6.0 Months, the difference between the two was statistically significant (P <0.01). Conclusion: The efficacy of AP and TP regimens in patients with advanced NSCLC who are resistant to EGFR-TKI therapy is similar. Smokers are less effective than non-smokers.