Clinical observation of the second-line chemotherapy of pemetrexed combined with cisplatin in the treatment of unresectable advanced gastric cancer

ObjectiveTo evaluate the efficacy and adverse reaction of the second-line chemotherapy of pemetrexed combined with cisplatin(PemCis) in the treatment of unresectable advanced gastric cancer(AGC), and analyze the survival time of patients with second-line chemotherapy.

MethodsSixty-three patients with unresectable AGC, who failed to the first-line chemotherapy, were divided into the observation group(34 cases treated with second-line chemotherapy of PemCis for two cycles at least) and control group(29 cases treated with best supportive care).The response rate(RR) and disease control rate(DCR) in observation group were calculated to evaluate the adverse reaction.The progression-free survival time-2(PFS-2) and overall survival(OS) in two groups were followed up.

ResultsThe short-term efficacy in observation group was evaluated, the complete remission in 1 case, partial remission in 8 cases, stability in 10 cases and progress in 15 cases were identified, and the RR and DCR were 26.5%, and 55.9%, respectively.The major side effects in observation group were grade 1-2 bone marrow suppression, fatigue, nausea and vomiting, the eucopenia was grade 3-4 toxic reaction, and the incidence rate of grade 3 and 4 were 8.8% and 3.0%, respectively.No fever, renal dysfunction or chemotherapy-related death in all patients was identified.The PFS-2 of the observation group was 3.3 months.The OS in observation group and control group were 10.8 months(95%CI:7.5 to 14.1 months) and 5.8 months(95%CI:2.6 to 9.0 months), respectively, and the difference of which was statistically significant(P < 0.01).

ConclusionsThe second-line treatment with PemCis for unresectable AGC has good effect and tolerance, which can significantly prolong the survival time of patients compared with supportive care.