%0 Journal Article
%T 晚期肺腺癌化疗方案的优化
%A 姜达
%A 崔彦芝
%A 李颖
%A 郑飞
%A 黄芳
%J 肿瘤防治研究
%D 2015
%R 10.3971/j.issn.1000-8578.2015.07.010
%X 摘要 目的 通过比较不同化疗方案治疗晚期肺腺癌患者的疗效、不良反应、生存情况并分析影响药物 疗效的因素，为临床优化选择化疗方案提供依据。方法 回顾性分析141例ⅢB期至Ⅳ期肺腺癌初治患者 的临床病例资料，比较培美曲塞+奈达铂、培美曲塞+顺铂/卡铂和三代化疗药+顺铂/卡铂三种一线治疗方 案的疗效、不良反应、生存情况，并分析影响药物疗效的因素。结果 （1）药效：培美曲塞+奈达铂、培美 曲塞+顺铂/卡铂、三代化疗药+顺铂/卡铂组客观缓解率（objective response rate, ORR）分别为35%、25%、 18.52%，疾病控制率（disease control rate, DCR）分别为90%、82.5%、85.19%。三组间ORR、DCR比较，差 异无统计学意义（P均＞0.05）。（2）药物疗效影响因素：性别、年龄、吸烟史、有无慢性病、器官转移数目、有无脑转移均不会影响药物DCR。 亚组分析三个治疗组间及（培美曲塞 +奈达铂）组内比较上述因素下患者的 DCR差异均无统计学意义。应用培美 曲塞联合铂剂一线治疗晚期肺腺癌患 者，EGFR野生组的ORR与DCR分别 为28.57%、78.57%；突变组为30.77%、80.77%，差异无统计学意义（P均＞0.05）。（3）不良反应：培 美曲塞+奈达铂组白细胞计数减低发生率低于其他两组，差 异有统计学意义（P=0.007）。（4）生存分析： 培美曲塞+奈 达铂、培美曲塞+顺铂/卡铂、三代化疗药+顺铂/卡铂三组中位 无进展生存期（progression free survival，PFS）分别为8、5、7 月。含培美曲塞组间、含顺铂/卡铂组间比较，差异均有统计学 意义（P均＜0.05）。结论 培美曲塞+奈达铂方案一线治疗晚 期肺腺癌有相对较高的ORR及DCR趋势，中位PFS相对延长， 不良反应小，血液学毒性明显减低。性别、年龄、吸烟史、有 无慢性病、器官转移数目、有无脑转移等因素均不会影响药物 疗效；培美曲塞联合铂剂一线治疗晚期突变型肺腺癌疗效略 优于野生型的趋势。临床医师可酌情优选培美曲塞+奈达铂方 案对晚期肺腺癌患者进行一线治疗
%K A Meta-analysis
%K Chemotherapy Promotes Mesenchymal Stem Cells Homing by Enhancing Cytokine Receptors Expression on Tumor Cells
%K Expressions of MACC1 and c-Met Proteins in Lung Adenocarcinoma and Their Correlation with Postoperative Recurrence
%K Clinical Investigation on Qingfei Mixture Combined with Chemotherapy on Middle and Advanced Non-small Cell Lung Cancer
%K Predictive Factors for Customizing Chemotherapy on Advanced Lung Adenocarcinoma
%K Differences of Clinical Features and Short-term Efficacy Between Diffuse Large B-cell Lymphomas of HIV-infected and Non-HIV-infected Patients
%K Risk Factors Associated with Hematologic Toxicity in Concurrent Chemoradiotherapy and IMRT for Cervical Cancer
%K Clinical Investigation on Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Patients with Peritoneal Carcinomatosis from Epithelial Ovarian Cancer
%K Role of IL-6 in Progress of Estrogen Promoting Lung Adenocarcinoma in Mice and Its Mechanism
%K Killing Effect of Paclitaxel and Cisplatin on EGFR-wild and Mutant Lung Adenocarcinoma Cells and Related Molecular Mechanism
%U http://www.zlfzyj.com/CN/abstract/abstract8539.shtml