College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Curr Oncol. 2012 Feb;19(1):e9-e15. doi: 10.3747/co.19.891.
Platinum-based regimens represent the standard first-line treatment for non-small-cell lung cancer (nsclc). However, newer data have established a role for pemetrexed in the treatment of this disease. Such data suggest that histology represents a determining factor in the selection of treatment.
We undertook a systematic review of the literature for randomized controlled trials that compared the efficacy of pemetrexed with that of other treatments in advanced nsclc. Data and study quality were assessed according to published guidelines.
We identified five trials that compared pemetrexed with other treatments or with placebo. Overall survival for patients treated with pemetrexed was superior to that with other treatments: hazard ratio (hr): 0.89; 95% confidence interval (ci): 0.80 to 0.99. The survival benefit was limited to patients with non-squamous histology: hr: 0.82; 95% ci: 0.73 to 0.91. Pemetrexed was inferior to other chemotherapy options in patients with squamous histology: hr: 1.19; 95% ci: 0.99 to 1.43.
Compared with other chemotherapy agents, pemetrexed is more effective for the treatment of nsclc in patients with non-squamous histology.
铂类方案是治疗非小细胞肺癌（nsclc）的标准一线治疗方案。然而，新的数据已经确立了培美曲塞在治疗这种疾病中的作用。这些数据表明组织学是选择治疗方法的决定因素。
我们对比较培美曲塞与其他治疗方法在晚期非小细胞肺癌中的疗效的随机对照试验进行了系统评价。根据已发表的指南评估数据和研究质量。
我们确定了五项比较培美曲塞与其他治疗方法或安慰剂的试验。接受培美曲塞治疗的患者的总生存期优于其他治疗方法：风险比（hr）：0.89；95%置信区间（ci）：0.80 至 0.99。生存获益仅限于非鳞状组织学患者：hr：0.82；95%置信区间（ci）：0.73 至 0.91。培美曲塞在鳞状组织学患者中的疗效不如其他化疗选择：hr：1.19；95%置信区间（ci）：0.99 至 1.43。
与其他化疗药物相比，培美曲塞在治疗非鳞状组织学的 nsclc 患者中更有效。
