CAJ | 학술논문

目的：观察吸烟对肺腺癌患者培美曲塞联合顺铂治疗疗效的影响。方法分析2010年2月~2012年2月徐州医学院附属医院肿瘤科收治的83例经病理学或细胞学确诊的初治ⅢB、Ⅳ期肺腺癌患者。吸烟组33例，不吸烟组50例，初治采用培美曲塞联合顺铂方案（培美曲塞500mg·m-2第1天静脉滴注，顺铂30mg·m-2第1～3天静脉滴注）化疗，21天为1个周期，每治疗两个周期后评价疗效，直至病情进展。近期疗效评价指标为疾病控制率（DCR），远期疗效评价指标为疾病进展时间（TTP）和1年生存率，毒副反应评价指标为骨髓抑制毒性、消化道反应等。结果吸烟组与不吸烟组 DCR 分别为60.6％和76.0％；TTP 分别为（5.7±1.6）月和（6.7±1.8）月，1年生存率分别为24.24％和46.0％。两组 DCR 比较（χ2=2.238，P=0.135），差异无统计学意义，TTP（t=2.55,P=0.013）及1年生存率（χ2=4.022,P=0.045）的差异有统计学意义。吸烟组与不吸烟组骨髓抑制毒性、消化道反应、口腔炎/咽炎、感染发生率的差异均无统计学意义（P>0.05）。结论不吸烟晚期肺腺癌患者一线应用培美曲塞治疗较吸烟患者可有更明显的远期获益。
목적：관찰흡연대폐선암환자배미곡새연합순박치료료효적영향。방법분석2010년2월~2012년2월서주의학원부속의원종류과수치적83례경병이학혹세포학학진적초치ⅢB、Ⅳ기폐선암환자。흡연조33례，불흡연조50례，초치채용배미곡새연합순박방안（배미곡새500mg·m-2제1천정맥적주，순박30mg·m-2제1～3천정맥적주）화료，21천위1개주기，매치료량개주기후평개료효，직지병정진전。근기료효평개지표위질병공제솔（DCR），원기료효평개지표위질병진전시간（TTP）화1년생존솔，독부반응평개지표위골수억제독성、소화도반응등。결과흡연조여불흡연조 DCR 분별위60.6％화76.0％；TTP 분별위（5.7±1.6）월화（6.7±1.8）월，1년생존솔분별위24.24％화46.0％。량조 DCR 비교（χ2=2.238，P=0.135），차이무통계학의의，TTP（t=2.55,P=0.013）급1년생존솔（χ2=4.022,P=0.045）적차이유통계학의의。흡연조여불흡연조골수억제독성、소화도반응、구강염/인염、감염발생솔적차이균무통계학의의（P>0.05）。결론불흡연만기폐선암환자일선응용배미곡새치료교흡연환자가유경명현적원기획익。
Objective To evaluate the effects of smoking on efficacy of pemetrexed combined cisplatin in advanced lung adeno-carcinoma. Methods A total of 83 cases from the department of oncology of Affiliated Hospital of Xuzhou Medical College between February 2010 and February 2012 were included. All patients were pathologically or cytologically diagnosed with IIIB, IV lung ad-enocarcinoma. There were 33 cases of smoking and 50 cases of non-smoking. All patients were under initial treatment in every three weeks method with pemetrexed 500 mg·m-2 on day 1 and cisplatin 30 mg·m-2 on day 1~3. Evaluation was performed at the end of every two cycles, until disease progression. The short-term efficacy evaluation contains complete remission (CR), partial remission (PR), stable disease (SD) and progression (PD). Time to progress (TTP) and 1-year survival rate were used as the long-term efficacy evaluation. The toxicity mainly includes myelosuppression, gastrointestinal reactions. Results Compared the smoking group with the non-smoking group, their DCR, TTP and the 1-year survival rate were respectively 60.6% vs. 76.0%, (5.7±1.6) vs. (6.7±1.8) months, 24.24% vs. 46.0%. There was no statistic difference in DCR (χ2=2.238, P=0.135), but there was statistically significant differences in TTP (t=2.55, P=0.013) and 1-year survival rate (χ2=4.022, P=0.045) between two groups. In addition, myelosup-pression, gastrointestinal reactions, Stomatitis/pharyngitis and infection in the two groups were not statistically different (P>0.05). Conclusion The non-smoking patients with advanced lung adenocarcinoma may have a greater long-term benefit than those smok-ing under first-line therapy of pemetrexed.