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培美曲塞治疗非小细胞肺癌无症状脑转移临床分析
         
Clinical efficacy of pemetrexed in the treatment of non-small cell lung cancer with asymptomatic brain metastasis

摘    要
目的:培美曲塞已被确定为晚期非小细胞肺癌(非鳞癌)的标准用药之一。本研究旨在探讨培美曲塞治疗非小细胞肺癌无症状脑转移的近期疗效和不良反应。方法:回顾性分析2008年11月-2010年12月45例非小细胞肺癌无症状脑转移患者的临床资料,评价疗效和不良反应。结果:所有患者颅内转移灶的疗效:部分缓解17例(37.8%),疾病稳定20例(44.4%),疾病进展8例(17.8%),客观缓解率为37.8%,疾病控制率为82.2%。全身病灶的总体疗效:部分缓解5例(11.1%),疾病稳定16例(35.6%),疾病进展24例(53.3%),客观缓解率为35.6%,疾病控制率为46.6%。颅内转移灶与全身病灶的疾病控制率差异有统计学意义(P=0.006),而客观缓解率差异无统计学意义(P>0.05)。颅内转移灶的无进展生存期为3.87个月,全身病灶的中位无进展生存期为2.27个月,差异有统计学意义(P=0.009)。颅内转移灶的近期疗效与患者年龄、性别、吸烟状况、脑转移灶数目、是否接受放疗等临床特征之间无明显相关性(P>0.05)。未观察到严重不良反应。结论:培美曲塞对于非小细胞肺癌脑转移患者颅内转移灶具有较好的疗效,不良反应较小。
标    签 癌,非小细胞肺   脑转移   培美曲塞   Carcinoma,non-small cell lung   Brain metastasis   Pemetrexed  
 
Abstract
Objective:Pemetrexed is a multitargeted antifolate inhibitor used as a standard agent in patients with advanced non-small cell lung cancer(NSCLC)(non-squamous cell).The purpose of this study was to evaluate the short-term efficacy and adverse effects of pemetrexed in the treatment of NSCLC patients with asymptomatic brain metastasis.Methods:The clinical records of 45 NSCLC patients with asymptomatic brain metastasis receiving pemetrexed between November 2008 and December 2010 were analyzed.The efficacy and adverse effects were evaluated.Results:Local cerebral response assessment showed that 17 patients(37.8%) got a partial response(PR),20(44.4%) had a stable disease(SD) and 8(17.8%) had a progressive disease(PD).The objective response rate was 37.8%,and the disease control rate was 82.2%.General lesion assessment presented that 5(11.1%),16(35.6%) and 24(53.3%) patients got PR,SD and PD,respectively.The objective response rate was 35.6%,and the disease control rate was 46.6%.There was a significant difference in the disease control rate(P=0.006) but not in the objective response rate(P>0.05) between the local cerebral disease and the general lesion.Median progression-free survivals for cerebral and extracerebral diseases were 3.87 months and 2.27 months,respectively(P=0.009).The short-term efficacy of cerebral disease was not associated with age,gender,smoking status,the number of brain metastatic lesions and radiotherapy.No serious adverse events were observed.Conclusion:Pemetrexes demonstrates a higher efficacy against cerebral metastasis of NSCLC,and the adverse effects are minor.

中图分类号 R734.2   DOI 10.3781/j.issn.1000-7431.2011.08.015

 
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所属栏目 临床研究

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收稿日期 2011/3/9

修改稿日期 2011/5/5

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引用该论文: HU Qiong,REN Sheng-xiang,LI Ai-wu,CHEN Xiao-xia,CHEN Jia-yan,MENG Shu-yan,HE Ya-yi,WANG Yong-sheng,KUANG Peng,LI Bing,ZHOU Cai-cun. Clinical efficacy of pemetrexed in the treatment of non-small cell lung cancer with asymptomatic brain metastasis[J]. Tumor, 2011, 31(8): 756~760
胡琼,任胜祥,李爱武,陈晓霞,陈佳艳,孟淑燕,何雅亿,王永生,况鹏,李冰,周彩存. 培美曲塞治疗非小细胞肺癌无症状脑转移临床分析[J]. 肿瘤, 2011, 31(8): 756~760


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参考文献
【1】RIZZI A, TONDINI M, ROCCO G, et al. Lung cancer with a single brain metastasis:therapeutic options[J]. Tumori, 1990, 76(6):579-581.
 
【2】LANGER C J, MEHTA M P. Current management of brain metastases, with a focus on systemic options[J]. J Clin Oncol, 2005, 23(25):6207-6219.
 
【3】BORGELT B, GELBER R, KRAMER S, et al. The palliation of brain metastases:Final results of the first two studies by the radiation therapy oncology group[J]. Int J Radiat Oncol Biol Phys, 1980, 6(1):1-9.
 
【4】PATCHELL R A, TIBBS P A, WALSH J W, et al. A randomized trial of surgery in the treatment of single metastases to the brain[J]. N Engl J Med, 1990, 322(8):494-500.
 
【5】DIENER-WEST M, DOBBINS T W, PHILLIPS T L, et al. Identification of an optimal subgroup for treatment evaluation of patients with brain metastases using RTOG study 7916[J]. Int J Radiat Oncol Biol Phys, 1989, 16(3):669-673.
 
【6】CORTES J, RODRIGUEZ J, ARAMENDIA J M, et al. Frontline paclitaxel/cisplatin-based chemotherapy in brain metastases from non-small-cell lung cancer[J]. Oncology, 2003, 64(1):28-35.
 
【7】MINOTTI V, CRINÒ L, MEACCI M L, et al. Chemotherapy with cisplatin and teniposide for cerebral metastases in non small-cell lung cancer[J]. Lung Cancer, 1998, 20(2):93-98.
 
【8】FUJITA A, FUKUOKA S, TAKABATAKE H, et al. Combination chemotherapy of cisplatin, ifosfamide, and irinotecan with rhG-CSF support in patients with brain metastases from non small cell lung cancer[J]. Oncology, 2000, 59(4):291-295.
 
【9】MEHTA M, RODRIGUS P, TERHAARD C, et al. Motexafin gadolinium prolongs time to neurologic progression in Lung cancer patients with brain metastases:results of a randomized phaseⅢtrial[J]. Int J Radiat Oncol Biol Phys, 2002, 54(Suppl 2):154.
 
【10】HOTTA K, KIURA K, UEOKA H, et al. Effect of gefitinib (‘Iressa’, ZD1839) on brain metastases in patients with advanced non-small cell lung cancer[J]. Lung Cancer, 2004, 46(2):255-261.
 
【11】FEKRAZAD M H, RAVINDRANATHAN M, JONES D V JR. Response of intracranial metastases to erlotinib therapy[J]. J Clin Oncol, 2007, 25(31):5024-5029.
 
【12】FIDLER I J, YANO S, ZHANG R D, et al. The seed and soil hypothesis:vascularization and brain m etastases[J]. Lancet Oncol, 2002, 3(1):53-57.
 
【13】Kim K H, Lee J, Lee J I, et al. Can upfront systemic chemotherapy replace stereotactic radiosurgery or whole brain radiotherapy in the treatment of non-small cell lung cancer patients with asymptomatic brain metastases[J]. Lung Cancer, 2010, 68(2):258-263.
 
【14】LEE J S, PISTERS K M, KOMAK I R, et al. Systemic chemotherapy as a primary treatment of brain metastases in patients with non-small cell lung cancer (NSCLC)[J]. Lung Cancer, 2000, 29 (Suppl 1):4.
 
【15】ALBEROLA V, CAMPS C, PROVENC IO M, et al. Cisplatin plus gemcitabine versus a cisplatin based triplet versus nonplatinum sequential doublets in advanced non-small cell lung cancer:a Spanish Lung Cancer Group phaseⅢrandomized trial[J]. J Clin Oncol, 2003, 21(17):3207-3213.
 
【16】CRIN L, SCAGLIOTTI G V, RICC I S, et al. Gemcitabine and cisplatin versus mitomycin, ifosfamide, and cisplatin in advanced non-small cell lung cancer:a randomized phaseⅡstudy of the Italian Lung Cancer Project[J]. J Clin Oncol, 1999, 17(11):3522-3530.
 
【17】LEE J S, PISTERS K M, KOMAK I R, et al. Systemic chemotherapy as a primary treatment of brain metastases in patients with non small cell lung cancer (NSCLC)[J]. Lung Cancer, 2000, 29(Suppl 1):4.
 
【18】SCAGLIOTTI G V, DE MARINIS F, RINALDI M, et al. PhaseⅢrandomized trial comparing three platinum-based doublets in advanced non-small cell lung cancer[J]. J Clin Oncol, 2002, 20(21):4285-4291.
 
【19】GALETTA D, GEBBIA V, SILVESTRIS N, et al. Cisplatin, fotemustine and whole-brain radiotherapy in non-small cell lung cancer patients with asymptomatic brain metastases:A multicenter phaseⅡstudy of the Gruppo Oncologico Italia Meridionale (GOIM 2603)[J]. Lung Cancer, 2011, 72(1):59-63.
 
【20】PEEREBOOM D M. Chemotherapy in brain metastases[J]. Neurosurgery, 2005, 57(5 Suppl):S54-S65.
 
【21】KIM J H, KIM H S, KWON J H, et al. Systemic chemotherapy after cranial irradiation in patients with brain metastases from non small cell lung cancer:a retrospective study[J]. Lung Cancer, 2009, 63(3):405-409.
 
【22】ROBINET G, THOMAS R, BRETON J L, et al. Results of a phaseⅢstudy of early versus delayed whole brain radiotherapy with concurrent cisplatin and vinorelbine combination in inoperable brain metastasis of non-small-cell lung cancer:Groupe Franaise de Pneumo-Cancerologie (GFPC) Protocol 95-1[J]. Ann Oncol, 2001, 12(1):59-67.
 
【23】GERSTNER E R, FINE R L. Increased permeability of the blood-brain barrier to chemotherapy in metastatic brain tumors:establishing a treatment paradigm[J]. J Clin Oncol, 2007, 25(16):2306-2312.
 
【24】SCAGLIOTTI G V, PARIKH P, VON PAWEL J, et al. PhaseⅢstudy comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy naïve patients with advanced-stage non small cell lung cancer[J]. J Clin Oncol, 2008, 26(21):3543-3551.
 
【25】HANAN N, SHEPHERD F A, FOSSELLA F V, et al. Randomized phaseⅢtrial of pemetrexed versus docetaxel in patients with non-small cell lung cancer previous treated with chemotherapy[J]. J Clin Oncol, 2004, 22(9):1589-1597.
 
【26】BEARZ A, GARASSINO I, TISEO M, et al. Activity of pemetrexed on brain metastases from non-small cell lung cancer[J]. Lung Cancer, 2010, 68(2):264-268.
 
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