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題名 | Pemetrexed as Third-line Chemotherapy for Locally Advanced and Metastatic Non-small Cell Lung Cancer (NSCLC): A Retrospective Analysis=局部晚期及轉移性非小細胞肺癌使用Pemetrexed當作第三線化學治療之治療成效--回溯性分析 |
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作者 | 吳佳哲; 邱泰然; 林孟志; 王瑞隆; 饒坤銘; 陳彥仰; 黃承華; Wu, Chia-che; Chiu, Tai-jan; Lin, Meng-chih; Wang, Jui-long; Rau, Kun-ming; Chen, Yen-yang; Huang, Cheng-hua; |
期刊 | 臺灣癌症醫學雜誌 |
出版日期 | 20110800 |
卷期 | 27:4 2011.08[民100.08] |
頁次 | 頁157-164 |
分類號 | 415.468 |
語文 | eng |
關鍵詞 | 非小細胞肺癌; 第三線化學治療; Non-small cell lung cancer; Pemetrexed; Third-line chemotherapy; |
中文摘要 | 背景:目前對於非小細胞肺癌並無標準的第三線化學藥物治療方式,本研究試圖評估pemetrexed當作第三線化學治療或之後的療效。 方法:回顧在兩線化學治療之後(不計標靶藥物),使用pemetrexed 當作第三線或之後時的病歷資料,並根據其第一線化學治療成效,分成「一直有效」、「打到沒效」、「一直沒效」三組來分析。 結果:總共有97位病人接受pemetrexed當作第三線或之後的化學治療。在第三線這組,反應率為4.5%,中值疾病惡化時間是2.8個月;在第四線之後,反應率為3.8%,中值疾病惡化時間是2.9個月。再次分析中,部分反應率的部分,在「一直有效」這組是8.1%,而「一直沒效」這組則是3.4%,但在「打到沒效」這組,則沒有部分反應率,在這三組中值疾病惡化時間則沒有統計學上的意義。 結論:pemetrexed當作第三線的化學治療應有一定的角色,而根據第一線化學藥物治療的效果,可能可以當作一個預測因子。 |
英文摘要 | Background: There are no drugs approved for third-line chemotherapy in non-small cell lung cancer(NSCLC) and no clinical trials to find an optimal third-line regimen. It is our intention to validate pemetrexed as third-line chemotherapy and to find predictors for a possible response group. Methods: Medical records of NSCLC patients who were administered pemetrexed when failing two lines of current chemotherapy were collected. In these patients, tyrosine kinase inhibitors were not counted in as a line of chemotherapy. We classified the status before pemetrexed into responsive, responsive-to-progression, and non-responsive groups, and tried to find predictors for pemetrexed responsiveness. Results: Ninety seven patients, who received pemetrexed as third-line chemotherapy or later, were eligible for analysis. In pemetrexed as third-line chemotherapy, the response rate was 4.5% and median TTP was 2.8 months; in fourth-line or later, the response rate was 3.8% and median TTP was 2.9 months. In responsive and non-responsive groups, partial response was 8.1% in the responsive group and 3.4% in the non-responsive group. No partial response was noted in responsive-to-progression group. There was no difference in median TTP between these three groups. Conclusions: When failing two lines of chemotherapy, pemetrexed still has a modest role as third-line chemotherapy. The response status to first-line platinum doublet might be predictive. However, a prospective study is needed to prove this hypothesis. |
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