ABSTRACT
OBJECTIVE: To investigate the factors that influence the progression-free survival time (PFS) of patients with non-squamous cell carcinoma type non-small cell lung cancer (NSCLC) after first chemotherapy, and to provide reference for the formulation of clinical individual treatment regimen. METHODS: Clinical information of 84 patients with non-squamous cell carcinoma type NSCLC after first chemotherapy were selected from our hospital during Jan. 2012-Dec. 2014. The effects of patient's factors [gender, age, performance status (PS) score], disease factors [tumor staging, tumor marker (TM) level] and treatment factors (chemotherapy regimen and treatment course, chemotherapy efficacy) on PFS were analyzed retrospectively. RESULTS: All patients were followed up for 11. 933 months averagely (final follow-up time of Jun. 30th, 2017), and their median PFS was 4. 017 months. The median PFS of male was slightly shorter than that of female; the median PFS of patients aged more than 65 year-old was slightly shorter than that of patients aged below 65 year-old; the median PFS of patients with PS score of 0-1 was slightly longer than that of patients with PS score of 2-4, without statistical significance (P＞0. 05). The median PFS of Ⅱ -Ⅲ stage patients was significantly longer than that of Ⅳ stage patients; the median PFS of patients with at least one TM index was 10 times higher than the upper limit of the normal value was significantly shorter than that of patients with four TM indexes were all 10 times lower than the upper limit of the normal value; the median PFS of patients underwent 1-3 treatment courses was significantly shorter than that of patients underwent 4-6 treatment courses; the median PFS of patients with progressive disease efficacy was significantly shorter than that of patients with stable disease efficacy or above, with statistical significance (P＜0. 05). Among 84 patients, 81 patients selected PP regimen (pemetrexed disodium+platinum), and other patients chose non-PP regimen. Due to the large difference in the number of cases, the effect of the chemotherapy regimen on the patient' s PFS was not investigated. CONCLUSIONS: The disease factor and treatment factor of patients may be associated with PFS. Tumor staging, at least one TM index was 10 times higher than the upper limit of the normal value, the number of completed chemotherapy treatment course, chemotherapy efficacy are independent influential factors of PFS in patients with non-squamous cell carcinoma type NSCLC.
ABSTRACT
Objective To observe the efficacy and safety of salvianolate injection combined with pemetrexed and carboplatin in the treatment of elderly patients with advanced non-squamous non-small-cell lung cancer.Methods 58 elderly patients with advanced non-squamous non-small-cell lung cancer in primary treatment were diagnosed by histopathology or cytology confirmation,and they were randomly divided into two groups (29 patients for control group and 29 patients for observation group).The control group was subjected to pemetrexed plus carboplatin chemotherapy,while the observation group was subjected to salvianolate injection based on the treatment of the control group by intravenous drip for 14 days,once a day,200 mg per day,and 21 days was a cycle.The changes of the efficacy,quality of life,the incidence of adverse reactions and the coagulation indicators in the patients of the two groups were compared after 4 cycles.Results The response rates and disease control rates in observation group were 44.8 ％ (13/29),86.2 ％ (25/29) and 37.9 ％ (11/29),75.8 ％ (22/29).It was found that the comparison of efficacy between the two groups did not make any statistical differences (P ＞ 0.05).The improvement of the quality of life in the observation group [82.7 ％ (24/29)] was better than that of the control group [65.5 ％ (19/29)] (P ＜ 0.05).The hematologic toxicity and gastrointestinal reaction rate in the observation group was lower compared with the control group (P ＜ 0.05).Moreover,the improvement of the hypercoagulable states in the observation group was better than that of the control group (P ＜ 0.05).Conclusions The treatment on elderly patients with advanced non-squamous non-small-cell lung cancer by salvianolate injection combined with pemetrexed and carboplatin can reduce the adverse effects caused by chemotherapy,improve the quality of life and the hypercoagulable states.Thereby it might prevent the occurrence of thromboembolic complications.
ABSTRACT
Objective To assess the clinical efficacy and adverse effect of pemetrexed-based chemotherapy as first-line treatment in elderly patients with advanced non-squamous non-small-cell lung cancer (NSCLC).Methods A total of 40 elderly patients with advanced non-squamous NSCLC confirmed by pathology were retrospective analyzed in the study,who received pemetrexed plus cisplatin (group A,n =18) or pemetrexed plus carboplatin (group B,n =22) as the first-line treatment.RECIST was used to assess the efficacy of the treatment and NCI-CTC AE version was used to describe adverse events.Results In the 40 patients,no one received complete response (CR),17 patients showed partial response (PR),16 had stable disease (SD),7 had progress disease (PD),the objective response rate (ORR) was 42.5 ％ (17/40) and the disease control rate (DCR) was 82.5 ％ (33/40).The median progression-free survival (PFS) time was 5.3 months.1 year suvival rate was 63.2 ％ (24/38).In further subgroup analyses,the ORR,DCR,PFS and 1 year suvival rate in group A were higher than those in group B,but they had no statistically significant difference (P ＞ 0.05).The drug-related adverse events were myelosuppression,gastrointestinal response,most of which were grade 1 to 2.Conclusion Pemetrexed combined with cisplatin or carboplatin may be recommended as first-line chemotherapy for elderly patients with advanced non-squamous NSCLC because of its safety and efficacy.