摘要
目的探讨培美曲塞单药或联合吉非替尼治疗表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)耐药晚期非小细胞肺癌的临床效果。方法选择延安大学咸阳医院2014年8月至2018年4月收治的EGFR-TKI耐药晚期非小细胞肺癌患者80例,对患者的资料进行回顾性分析。依据治疗方式分组:接受培美曲塞单药治疗的40例为对照组,接受培美曲塞联合吉非替尼治疗的40例为观察组。比较两组近期疗效、不良反应及生存时间。计数资料比较采用χ^2检验或Fisher确切概率法,生存分析采用Kaplan-Meier法,应用log-rank法进行检验。结果观察组总有效率高于对照组[70.0%(28/40)比32.5%(13/40)],差异有统计学意义(χ^2=11.257,P=0.001)。观察组不良反应发生率与对照组比较[17.5%(7/40)比20.0%(8/40)],差异无统计学意义(χ^2=0.082,P=0.775)。观察组中位无进展生存时间、中位总生存时间均长于对照组(6.5个月比3.5个月,15.5个月比8.5个月),差异均有统计学意义(均P<0.01)。结论采用培美曲塞联合吉非替尼治疗EGFR-TKI耐药晚期非细胞肺癌近期疗效较好,不良反应发生率低,患者生存时间延长,值得推广。
Objective To investigate the clinical efficacy of pemetrexed alone or combined with gefitinib in treatment of advanced non-small cell lung cancer (NSCLC) after epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) drug resistance. Methods The clinical data of 80 patients with advanced NSCLC after EGFR-TKI drug resistance from August 2014 to April 2018 were retrospectively analyzed. They were divided into two groups according to their treatment regimens: 40 patients received pemetrexed alone (the control group) and 40 patients received pemetrexed combined with gefitinib (the observation group). The recent clinical efficacy, adverse reactions and the survival time of both groups were compared. The count data was compared by using χ 2 test or Fisher exact test. Kaplan-Meier method was used to make survival analysis and log-rank method was used to detect. Results The total effective rate of the observation group was higher than that of the control group [70.0%(28/40) vs. 32.5%(13/40),χ^2 = 11.257, P = 0.001]. There was no statistical difference in the adverse reactions [17.5%(7/40) vs. 20.0%(8/40),χ^2 = 0.082, P = 0.775]. The median progression-free survival time and median overall survival time of the observation group were longer than those of the control group (6.5 months vs. 3.5 months, 15.5 months vs. 8.5 months, all P < 0.01). Conclusion Pemetrexed combined with gefitinib has a recent favorable effect in advanced NSCLC after EGFR-TKI drug resistance, including low incidence of adverse reactions and prolonged survival time, which is worthy of further application.
作者
殷国庆
王忠
周峰
冯媛
Yin Guoqing;Wang Zhong;Zhou Feng;Feng Yuan(Department of Oncology, Xianyang Hospital, Yan'an University, Xianyang 712000, China)
出处
《肿瘤研究与临床》
CAS
2019年第3期158-161,共4页
Cancer Research and Clinic
关键词
癌
非小细胞肺
抗药性
肿瘤
受体
表皮生长因子
蛋白酪氨酸激酶类
酶抑制剂
吉非替尼
培美曲塞
Carcinoma, non-small-cell lung
Drug resistance, neoplasm
Receptor, epidermal growth factor
Protein-tyrosine kinases
Enzyme inhibitors
Gefitinib
Pemetrexed
