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目的探讨培美曲塞与吉非替尼单药治疗一线化疗失败的晚期非小细胞肺癌(NSCLC)的疗效及安全性,为NSCLC的二线临床用药提供一定的参考依据。方法将符合入组标准的83例患者随机分成培美曲塞组(41例)和吉非替尼组(42例)进行治疗观察,两组患者在性别、年龄、病理类型、分期,吸烟史等方面大致平衡。评价两组患者的疗效、无进展生存时间(PFS)、中位生存时间(MST)和不良反应。结果比较两组患者的中位PFS、中位OS、肿瘤分期、一线接受化疗方案个数等指标,两组差异均无统计学意义(P>0.05),但吉非替尼组的血液学毒性明显低于培美曲塞组(P<0.05),症状改善及生活质量改善优于培美曲塞组(P<0.05)。结论在标准一线化疗失败的晚期NSCLC患者中,培美曲塞和吉非替尼单药二线治疗晚期非小细胞肺癌效率相近,但吉非替尼不良反应轻微,对症状和生活质量的改善率更高。
Objective To investigate the efficacy and safety of pemetrexed and gefitinib monotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) with first-line chemotherapy failure, and to provide a reference for the second-line clinical use of NSCLC. Methods Eighty-three patients who met the inclusion criteria were randomly divided into pemetrexed group (n = 41) and gefitinib group (n = 42). The patients were divided into two groups according to gender, age, pathological type, And other aspects of the general balance. Efficacy, progression-free survival time (PFS), median survival time (MST) and adverse reactions in both groups were evaluated. Results The median PFS, median OS, tumor stage and the number of first-line chemotherapy regimens were compared between the two groups. There was no significant difference between the two groups (P> 0.05). However, the hematological toxicity (P <0.05). The improvement of symptoms and quality of life were better than pemetrexed group (P <0.05). Conclusions Peracetase and gefitinib monotherapy second-line treatment of advanced non-small cell lung cancer in the efficiency of the standard first-line chemotherapy failure in patients with advanced NSCLC similar efficiency, but gefitinib mild adverse reactions, the improvement of symptoms and quality of life higher.