Reck Martin, Gatzemeier Ulrich
Department of Thoracic Oncology, Hospital Grosshansdorf, Center of Pneumology and Thoracic Surgery, Woehrendamm 80, D-22927 Grosshansdorf, Germany.
Lung Cancer. 2004 Aug;45 Suppl 2:S217-22. doi: 10.1016/j.lungcan.2004.07.972.
Since cisplatin-based chemotherapy was proven to increase survival in advanced and metastatic NSCLC various new combinations have been tested. The third generation regimens which showed almost comparable efficacy among each other in randomised trials often proved a better response rate and time to progression combined with a remarkable reduction of toxic side effects compared to "classic" combinations, whereas most studies only noted a modest increase in survival. Two-drug regimens were more effective than monotherapy but at the expense of significantly increased toxicity, while monotherapy compared to BSC improved quality of life and survival. The novel antifolate Pemetrexed proved comparable activity to docetaxel with significantly reduced toxicities.
由于基于顺铂的化疗已被证明可提高晚期和转移性非小细胞肺癌（NSCLC）患者的生存率，因此人们对各种新的联合化疗方案进行了测试。在随机试验中，第三代化疗方案之间显示出几乎相当的疗效，与“经典”联合化疗方案相比，其通常具有更高的缓解率和疾病进展时间，同时毒副作用显著减少，而大多数研究仅表明生存率有适度提高。两药联合方案比单一疗法更有效，但代价是毒性显著增加，而单一疗法与最佳支持治疗（BSC）相比可改善生活质量和生存率。新型抗叶酸药物培美曲塞被证明与多西他赛活性相当，但毒性显著降低。
