Impact of platinum/pemetrexed combination versus other platinum-based regimens on adjuvant chemotherapy in resected lung adenocarcinoma.
Impact of platinum/pemetrexed combination versus other platinum-based regimens on adjuvant chemotherapy in resected lung adenocarcinoma.
复制标题
DOI：
10.1038/s41598-017-01347-6
复制
发表时间：
2017-05-03
影响因子：
4.6
通讯作者：
Wang Z
中科院分区：
文献类型：
--
作者：
Zhai X;Zheng Q;Yang L;Zhu Y;Li J;Liu Y;Wang Z
对于晚期非鳞状非小细胞肺癌（NSCLC），尽管已知铂类/培美曲塞与其他方案相比可延长生存期，但辅助治疗的结局仍未知。本研究关注铂类/培美曲塞与其他铂类药物双联治疗肺腺癌患者之间无病生存期（DFS）的差异。对389例接受铂类/培美曲塞辅助化疗（A组，n = 143）或其他第三代含铂方案（B组，n = 246）的肺腺癌根治术患者进行DFS分析。倾向分数匹配（PSM）允许生成两个类别的最佳匹配对。培美曲塞双联治疗组DFS明显更好（P = 0.0079）;与含吉西他滨的化疗相比，铂类/培美曲塞与几种血液学和非血液学不良事件（AE）的发生率较低相关（白细胞减少症：RR 0.514，p = 0.001;中性粒细胞减少症：RR 0.688，p = 0.002）或紫杉烷类药物双联治疗（白细胞减少症：RR 0.685，p = 0.019;中性粒细胞减少症：RR 0.805，p = 0.032）。对于根治性切除的肺腺癌患者，与非培美曲塞双联方案相比，铂类/培美曲塞辅助化疗可获得更好的DFS和更低的临床毒性。
For advanced non-squamous non-small cell lung cancer (NSCLC), although platinum/pemetrexed is known to result in a longer survival compared with other regimens, the outcome in the adjuvant setting is still unknown. In this study, the difference of the disease-free survival (DFS) between lung adenocarcinoma patients treated with platinum/pemetrexed and with other platinum-based doublets was concerned. A total of 389 radically resected lung adenocarcinoma patients received adjuvant chemotherapy with platinum/pemetrexed chemotherapy (Group A, n = 143) or other third generation platinum-based regimens (Group B, n = 246) were analyzed in terms of DFS. Propensity score matching (PSM) allowed generation of best matched pairs for the two categories. DFS was proved to be considerably better in pemetrexed doublets group (P = 0.0079); and platinum/pemetrexed was found to be associated with lower rates of several hematological and non-hematological adverse events (AEs), when compared with gemcitabine containing chemotherapy (leukopenia: RR 0.514, p = 0.001; neutropenia: RR 0.688, p = 0.002), or taxanes-doublets treatment (leukopenia: RR 0.685, p = 0.019; neutropenia: RR 0.805, p = 0.032). For patients with radically resected pulmonary adenocarcinoma, adjuvant chemotherapy with platinum/pemetrexed results in a better DFS and a less clinical toxicity in comparison with non-pemetrexed based doublets.