CAJ | 학술논문

目的：比较培美曲塞与厄洛替尼单药治疗一线化疗进展的晚期非小细胞肺癌的疗效、不良反应、生活质量及生存期，为晚期非小细胞肺癌的二线用药提供参考。方法：回顾性分析我科2011年3月～2013年10月门诊或住院收治的经病理组织学或细胞学检查证实为晚期非小细胞肺癌且经含铂类药物为一线标准化疗方案治疗失败的患者90例。其中培美曲塞组46例、厄洛替尼组44例。培美曲塞组采用500 mg／m2静滴，21 d一个周期。厄洛替尼组患者餐后2 h口服厄洛替尼150 mg／d。评价两组患者的临床疗效、无进展生存时间（ PFS）、中位生存时间（ MST）、不良反应和生活质量。结果：两组患者治疗有效率、疾病控制率、中位PFS、MST相比差异无统计学意义（ P＞0.05）。培美曲塞组主要不良反应是骨髓抑制和胃肠道反应，厄洛替尼主要不良反应是皮疹和腹泻，两组不良反应发生率比较差异有统计学意义（ P＜0.05）。厄洛替尼组在改善患者综合生活质量方面效果明显，优于培美曲塞组（ P＜0.05）。结论：培美曲塞和厄洛替尼单药二线治疗晚期非小细胞肺癌的疗效相似，不良反应各异，两者均能改善患者生活质量，但是厄洛替尼改善更明显。
목적：비교배미곡새여액락체니단약치료일선화료진전적만기비소세포폐암적료효、불량반응、생활질량급생존기，위만기비소세포폐암적이선용약제공삼고。방법：회고성분석아과2011년3월～2013년10월문진혹주원수치적경병리조직학혹세포학검사증실위만기비소세포폐암차경함박류약물위일선표준화료방안치료실패적환자90례。기중배미곡새조46례、액락체니조44례。배미곡새조채용500 mg／m2정적，21 d일개주기。액락체니조환자찬후2 h구복액락체니150 mg／d。평개량조환자적림상료효、무진전생존시간（ PFS）、중위생존시간（ MST）、불량반응화생활질량。결과：량조환자치료유효솔、질병공제솔、중위PFS、MST상비차이무통계학의의（ P＞0.05）。배미곡새조주요불량반응시골수억제화위장도반응，액락체니주요불량반응시피진화복사，량조불량반응발생솔비교차이유통계학의의（ P＜0.05）。액락체니조재개선환자종합생활질량방면효과명현，우우배미곡새조（ P＜0.05）。결론：배미곡새화액락체니단약이선치료만기비소세포폐암적료효상사，불량반응각이，량자균능개선환자생활질량，단시액락체니개선경명현。
Objective:To evaluate the clinical efficacy,toxicity,quality of life and the median progression-free survival (PFS) using pemetrexed and erlo-tinib as second line medication for advanced non-small cell lung cancer ( NSCLC) .Methods:The clinical outcomes were retrospectively examined in 90 patients confirmed as NSCLC by histopathology or cytological examination ,who failed to respond to first-line of platinum-based regimen chemotherapy and underwent second line treatment with pemetrexed(n=46) or erlotinib(n=44) on outpatient or hospitalization basis between March 2011 and October 2013 in our department.Group pemetrexed received intravenous administration of pemetrexed in dose of 500 mg/m2 for 21 days as a chemotherapy epi-sodes,and group erlotinib were given oral erlotinib in dose of 150 mg/d by postprandial 2 hour.The two groups were assessed regarding the efficacy,pro-gression-free survival time (PFS),median survival time (MST),incidence of toxicity and life quality.Results:The two groups were not significant pertain-ing to effective rate,disease control rate,median PFS and MST(P>0.05).The adverse effects in group pemetrexed were associated with bone marrow sup-pression and gastrointestinal reactions;and erlotinib,development of skin rash and diarrhea,which was statistically different(P<0.05).Erlotinib had bet-ter improved the quality of life for patients than pemetrexed(P<0.05).Conclusion:Although pemetrexed and erlotinib as second line therapy for NSCLC may lead to similar effects and improvement of the quality of life for patients ,yet the adverse effects vary to a certain degree and erlotinib has better out-comes of life quality.