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[目的]评价培美曲赛联合奥沙利铂用于晚期非小细胞肺癌二线治疗时的安全性和有效性。[方法2007年1月～2009年1月,一线治疗失败的晚期非小细胞肺癌患者中,一部分采用了培美曲赛单药或培美曲赛联合奥沙利铂化疗作为二线治疗,回顾他们的病历,并比较两组患者的临床特征,使用Kaplan-Meier法和时间等级检验分析两组之间生存期的差别。[结果]共79人纳入分析,34人使用PO方案(培美曲赛500mg/ml2d1+奥沙利铂125mg/m21,每21d重复),45人使用培美曲赛单药化疗。两组耐受性都较好,没有治疗相关性死亡发生,粒细胞减少是最常见的毒性反应。PO组的缓解率和肿瘤控制率分别为15.2%和63.6%,单药组则分别为11.1%、47.5%。PO组中位进展时间和中位生存期分别是18周(95%可信区间:13.72～22.28周)和31周(95%可信区间:15.56～46.44周),明显好于单药组(P值分别为0.002、0.006)。[结论]在晚期非小细胞肺癌的二线治疗中培美曲赛联合奥沙利铂化疗方案表现出与培美曲塞单药化疗方案相似的安全性和缓解率,生存期显著延长。
[Objective] To evaluate the safety and efficacy of pemetrexed combined with oxaliplatin for second-line treatment of advanced non-small cell lung cancer. METHODS: From January 2007 to January 2009, patients with advanced non-small cell lung cancer who failed first-line therapy were treated with either pemetrexed monotherapy or pemetrexed plus oxaliplatin chemotherapy as second-line therapy, reviewing them The medical records of the two groups were compared and the clinical characteristics of the two groups were compared. Kaplan-Meier method and time-grade test were used to analyze the differences in survival between the two groups. [Results] A total of 79 patients were enrolled in the analysis. 34 patients underwent PO regimen (Pemetrexed 500 mg / ml 2d1 + oxaliplatin 125 mg / m21, repeated every 21 days) and 45 patients received pemetrexed monotherapy. Both groups were well tolerated with no treatment-related deaths and neutropenia was the most common toxicity. The rates of remission and tumor control in PO group were 15.2% and 63.6% respectively, while those in single drug group were 11.1% and 47.5% respectively. The median progression time and median survival in PO group were 18 weeks (95% confidence interval: 13.72-22.28 weeks) and 31 weeks (95% confidence interval: 15.56-46.44 weeks), respectively, significantly better than those in the single drug group P values were 0.002, 0.006 respectively). [Conclusion] Pemetrexed combined with oxaliplatin in the second-line treatment of advanced non-small cell lung cancer shows safety and remission rate similar to that of pemetrexed single-agent chemotherapy and significantly prolongs the survival time.