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目的探讨培美曲塞单药或联合顺铂作为二线治疗方案治疗晚期复发或进展的非小细胞肺癌患者的疗效及毒副反应。方法回顾性总结接受培美曲塞二线治疗的50例晚期非小细胞肺癌患者,按照用药情况分为单药治疗组22例及联合铂类治疗组28例。评价2组近期疗效及不良反应。结果 50例患者均可评价疗效。2组均无CR病例。单药治疗组PR2例,SD10例,PD10例,有效率(CR+PR)9.1%,疾病控制率(CR+PR+SD)54.5%,中位无进展生存期3.8个月;联合治疗组PR3例,SD13例,PD8例,有效率7.1%,疾病控制率71.4%,中位无进展生存期4.8个月。2组比较,有效率及中位无进展生存期差异无统计学意义(P均>0.05),联合铂类治疗组疾病控制率较高(P<0.05)。与药物相关的不良反应主要为I/II度骨髓抑制、胃肠道反应、皮疹,与联合铂类治疗组比较,单药治疗组的副作用(红细胞减少、消化道反应)较低(P<0.05)。结论晚期非小细胞肺癌的二线治疗方案可选择培美曲塞单药或联合顺铂,安全性相对较好,但是两药联合治疗方案毒副反应略有增加。
Objective To investigate the efficacy and side effects of pemetrexed monotherapy or cisplatin as second-line treatment for patients with recurrent or advanced non-small cell lung cancer. Methods A retrospective review of 50 patients with advanced non-small cell lung cancer treated with pemetrexed second-line therapy was divided into 22 cases of monotherapy group and 28 cases of platinum group. Evaluation of two groups of recent efficacy and adverse reactions. Results 50 patients can evaluate the efficacy. There were no CR cases in both groups. In the monotherapy group, there were 2 PR2 cases, 10 cases SD10 cases and 10 cases PD. The effective rate (CR + PR) was 9.1%, the disease control rate was 54.5% and the median progression-free survival time was 3.8 months. Cases, SD13 cases, PD8 cases, the effective rate of 7.1%, disease control rate of 71.4%, the median progression-free survival of 4.8 months. There was no significant difference between the two groups in the effective rate and the median progression-free survival (P> 0.05). The combined treatment of platinum group had higher disease control rate (P <0.05). Drug-related adverse reactions were predominantly grade I / II myelosuppression, gastrointestinal reactions, and rashes, with fewer side effects (erythrocyte reduction, digestive tract response) in the monotherapy group than in the platinum-treated group (P <0.05 ). Conclusions The second-line treatment of advanced non-small cell lung cancer may choose pemetrexed alone or combined with cisplatin, which is relatively safe, but the side effects of the two drugs are slightly increased.