Pu Xiaolin, Li Wei, Lu Binbin, Wang Zhaoxia, Yang Min, Fan Weifei, Meng Lijuan, Lv Zhigang, Xie Yuchun, Wang Jun
Department of Oncology, Changzhou No. 2 People's Hospital, the Affiliated Hospital of Nanjing Medical University, Changzhou Department of Oncology, Department of Clinical Epidemiology, Jiangsu Province Geriatric Institute Department of Oncology, The First Affiliated Hospital of Nanjing Medical University Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University Department of Oncology, Jiangsu Province Geriatric Institute Central Laboratory, Jiangsu Province Geriatric Institute, Nanjing, China.
Medicine (Baltimore). 2017 Mar;96(11):e6002. doi: 10.1097/MD.0000000000006002.
To evaluate the clinical efficacy and toxicity of single pemetrexed treatment compared with platinum-based pemetrexed doublet pemetrexed-based as first-line treatment for advanced nonsquamous nonsmall cell lung cancer (NS-NSCLC) in elderly Chinese patients.
The study retrospectively reviewed 175 elderly Chinese patients with NS-NSCLC from June 2010 to September 2013: 90 patients received single pemetrexed treatment, 45 received pemetrexed plus oxaliplatin, and 40 received pemetrexed plus carboplatin. Clinical efficacy was assessed using disease control rate (DCR), overall survival (OS), and progression-free survival (PFS).
DCR, OS, and PFS did not significantly differ between single pemetrexed treatment (OS: 14.9 months; DCR: 62.2%; PFS: 3.3 months), pemetrexed plus oxaliplatin (OS: 16.5 months; DCR: 71.1%; PFS: 4.5 months), and pemetrexed plus carboplatin (OS: 15.5 months; DCR: 70.0%; PFS: 4.6 months) groups. Pemetrexed treatment caused significantly lower incidences of adverse events, such as hepatotoxicity and peripheral nerve injury. Performance status (PS), TNM stage, and Thymidylate synthase (TS) expression were predictive factors of DCR. Pemetrexed chemotherapy cycles, PS, and TNM stage were independent prognostic factors.
Single pemetrexed was noninferior to platinum-based pemetrexed doublet for clinical efficacy and safety in elderly Chinese patients with advanced NS-NSCLC. Chemotherapy cycles, performance status, and TNM stage were independent prognostic factors.
评估单药培美曲塞治疗与以铂类为基础的培美曲塞双联疗法作为老年中国患者晚期非鳞状非小细胞肺癌（NS-NSCLC）一线治疗的临床疗效和毒性。
该研究回顾性分析了2010年6月至2013年9月期间175例老年中国NS-NSCLC患者：90例接受单药培美曲塞治疗，45例接受培美曲塞联合奥沙利铂治疗，40例接受培美曲塞联合卡铂治疗。使用疾病控制率（DCR）、总生存期（OS）和无进展生存期（PFS）评估临床疗效。
单药培美曲塞治疗组（OS：14.9个月；DCR：62.2%；PFS：3.3个月）、培美曲塞联合奥沙利铂组（OS：16.5个月；DCR：71.1%；PFS：4.5个月）和培美曲塞联合卡铂组（OS：15.5个月；DCR：70.0%；PFS：4.6个月）之间的DCR、OS和PFS无显著差异。培美曲塞治疗导致的不良事件发生率显著较低，如肝毒性和周围神经损伤。体能状态（PS）、TNM分期和胸苷酸合成酶（TS）表达是DCR的预测因素。培美曲塞化疗周期、PS和TNM分期是独立的预后因素。
对于老年中国晚期NS-NSCLC患者，单药培美曲塞在临床疗效和安全性方面不劣于以铂类为基础的培美曲塞双联疗法。化疗周期、体能状态和TNM分期是独立的预后因素。
