CAJ | 학술논문

目的：研究培美曲塞诱导化疗后联合胸部放射治疗肺腺癌的疗效及不良反应。方法本研究回顾性分析了自2008年7月—2012年4月期间的Ⅲa／b或Ⅳ期的肺腺癌患者共95例。其中接受培美曲塞诱导化疗后联合胸部放疗的患者30例，接受紫杉醇诱导化疗后联合胸部放疗的患者33例，接受单纯培美曲塞化疗的患者32例，比较了接受三种不同治疗方式治疗中晚期肺腺癌患者的疾病缓解率、疾病无进展生存期、1年生存率以及不良反应率。结果培美曲塞联合放疗、紫杉醇联合放疗以及培美曲塞单纯化疗这三组不同治疗方案的疾病缓解率分别是为83．3％、81．8％和62．5％；无进展生存期分别为12．0个月、10．9个月和5．7个月；一年生存率分别为80．0％、78．7％和46．8％。其中培美曲塞联合放疗组的疗效明显优于单纯培美曲塞化疗组，不良反应发生率明显低于紫杉醇联合放疗组，差异均具有统计学意义（ P＜0．05）。结论培美曲塞联合放射治疗治疗中晚期肺腺癌可以明显延长患者的生存。同时与紫杉醇联合放疗相比较，在疗效近似的情况下具有不良反应轻的特点，患者耐受性更好。
목적：연구배미곡새유도화료후연합흉부방사치료폐선암적료효급불량반응。방법본연구회고성분석료자2008년7월—2012년4월기간적Ⅲa／b혹Ⅳ기적폐선암환자공95례。기중접수배미곡새유도화료후연합흉부방료적환자30례，접수자삼순유도화료후연합흉부방료적환자33례，접수단순배미곡새화료적환자32례，비교료접수삼충불동치료방식치료중만기폐선암환자적질병완해솔、질병무진전생존기、1년생존솔이급불량반응솔。결과배미곡새연합방료、자삼순연합방료이급배미곡새단순화료저삼조불동치료방안적질병완해솔분별시위83．3％、81．8％화62．5％；무진전생존기분별위12．0개월、10．9개월화5．7개월；일년생존솔분별위80．0％、78．7％화46．8％。기중배미곡새연합방료조적료효명현우우단순배미곡새화료조，불량반응발생솔명현저우자삼순연합방료조，차이균구유통계학의의（ P＜0．05）。결론배미곡새연합방사치료치료중만기폐선암가이명현연장환자적생존。동시여자삼순연합방료상비교，재료효근사적정황하구유불량반응경적특점，환자내수성경호。
Objective To compare the efficacy and toxicity of inductive chemotherapy with pemetrexed followed by radiotherapy for patients with lung adenocarcinoma .Methods Patients with stage Ⅲa/b or Ⅳ and histologically confirmed lung adenocarcinoma were evaluated from July 2008 to April 2012 ( n=95 ) .Patients re-ceived inductive chemotherapy with pemetrexed or paclitaxel followed by thoracic radiotherapy or chemotherapy with pemetrexed alone,respectively.Primary end point was the tumor response rate (RR),progression-free sur-vival(PFS),1-year survival rate and toxicity.Results Tumor RR were 83.3%,81.8%and 62.5% in three groups of inductive chemotherapy with pemetrexed or paclitaxel followed by thoracic radiotherapy or chemotherapy with pemetrexed alone ,respectively.PFS was 12.0 months,10.9 months and 5.7 months.The 1-year survival rate was 80.0%,78.7%and 46.8%.Tumor RR and PFS were statistically superior in pemetrexed/radiotherapy versus pemetrexed alone ,and toxicity was significantly lower than in paclitaxel /radiotherapy.Conclusion The treatment of pemetrexed/radiotherapy for lung adenocarcinoma could prolong the survival of patients .Compared with the treatment of paclitaxel/radiotherapy ,pemetrexed/radiotherapy provides similar efficacy with better tolera-bility and more convenient administration .