CAJ | 학술논문

目的探讨培美曲塞作为三线药物对于一线和二线治疗失败的晚期非小细胞肺癌(NSCLC)的治疗效果.方法对17例一线含铂化疗及二线表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)治疗无效后的NSCLC患者给予单药培美曲塞(600 mg/m2第1天,21 d为1个疗程)作为三线治疗,平均每例患者治疗周期中位数为6个疗程.观察疗效并分析患者性别、身体状态、给药周期数、EGFR基因型等对培美曲塞疗效的影响.结果 17例患者中9例部分缓解,5例稳定,3例进展.中位疾病进展时间及总生存期为113 d及321 d.EGFR基因型不影响培美曲塞的疗效,患者耐受良好.结论培美曲塞对一般状态良好的NSCLC患者在其对一线含铂化疗及二线TKIs靶向治疗无效时可作为三线药物,且与顺铂和KTIs没有交叉耐药.
목적 탐토배미곡새작위삼선약물대우일선화이선치료실패적만기비소세포폐암(NSCLC)적치료효과.방법 대17례일선함박화료급이선표피생장인자수체(EGFR)락안산격매억제제(TKIs)치료무효후적NSCLC환자급여단약배미곡새(600 mg/m2제1천,21 d위1개료정)작위삼선치료,평균매례환자치료주기중위수위6개료정.관찰료효병분석환자성별、신체상태、급약주기수、EGFR기인형등대배미곡새료효적영향.결과 17례환자중9례부분완해,5례은정,3례진전.중위질병진전시간급총생존기위113 d급321 d.EGFR기인형불영향배미곡새적료효,환자내수량호.결론 배미곡새대일반상태량호적NSCLC환자재기대일선함박화료급이선TKIs파향치료무효시가작위삼선약물,차여순박화KTIs몰유교차내약.
Objective To observe the effect of pemetrexed as a salvage chemotherapy for locally advanced or metastatic non-squamous non-small cell lung cancer (NSCLC) after failure of multiple therapies.Methods We retrospectively evaluated the efficacy of pemetrexed in 17 patients with advanced NSCLC,who had failed at least platinum-based doublet combinations and erlotinib or gefitinib.The patients were given single drug pemetrexed q21d dl (600 mg/m2) as a third line therapy.Through the analysis of performance status,number of cycles given,EGFR and K-ras mutation status,best response,adverse reactions,time to progression (TTP) and overall survival (OS) were used to assess the effects.A median of 6 cycles of infusion was given.Results Nine out of 17 patients experienced partial response,Five cases were stable and three were progressed.The TTP and OS of salvage pemetrexed therapy were 113 and 321 days,respectively.The EGFR mutation status did not affect its efficacy.It was well-tolerated and required no dose modification.Conclusion Pemetrexed is a good option for patients with good performance status who have failed platinum-and taxane-containing regimens and EGFR tyrosine kinase inhibitors.