培美曲塞联合卡铂治疗老年晚期非小细胞肺癌的临床观察  

Clinical research of pemetrexed combination with carboplatin as the therapy in advanced non-small cell lung cancer of seniurn

作　　者：赵珺[1] 

机构地区：[1]浙江省肿瘤医院肿瘤科,浙江省杭州310022

出　　处：《中国基层医药》2011年第8期1045-1047,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察培美曲塞（Pemetrexed，PEM）联合卡铂（carboplatin，CBP）治疗老年晚期非小细胞肺癌（NSCLC）的有效性和毒副反应。方法49例老年晚期NSCLC患者接受PEM（500mg／m^2）联合CBP（AUC=5）方案化疗。21d为1个疗程，每例患者至少接受2个疗程。结果所有患者均可评价疗效，完全缓解（cR）0例，部分缓解（PR）23例，稳定（sD）21例，进展（PD）5例。总有效率（RR）为46．9％（23／49），NSCLC患者IIIB期有效率68．2％，明显高于Ⅳ期29．6％（X^2=3．879，P〈0．05），疾病进展时间（TTP）5．3个月，中位生存期（MST）11．2个月（3～21个月），1年生存率为54．3％。毒副反应主要有骨髓抑制、恶心呕吐、腹泻、肝功能受损及粒缺所致发热等。49例中，白细胞减少23例（46．9％）明显高于恶心11例（22．4％）、呕吐5例（10．0％）、肝功能异常4例（8．o％）。发热1例（2．0％）（f=3．879，P〈0．05；X^2=8．451、8．778、9．123、9．741，均P〈0．01）。结论培美曲塞联合卡铂方案可作为老年晚期NSCLC有效的一线化疗方案。Objective To evaluate the curative effect and toxic reaction of pemetrexed combination with carboplatin as the therapy in advanced non-small cell lung cancer（NSCLC） of senium. Methods A total of 49 chemotherapy naive patients with ⅢB or IV NSCLC were enrolled in this study. Pemetrexed was given at a dose of 500mg/m^2. Carboplatin dosed to an area under the time-concentration curve （AUC） of 5. The chemotherapy was repeated every 21 days. Each patient was given at least 2 cycles. Results The curative effects of all the patients were evaluated. Among the 49 patients,the symptoms of 23 had been partially response,21 stabilized and 5 progressed. The total effective rate was 46.9% （23/49）. The efficiency of 68.2% in NSCLC with IIIB phase were significantly higher than,29. 6% in NSCLC with IV phase （ X^2 = 3. 879, P 〈 0.05 ）, Median time to progression （TIP） was 5.3 months. Median survival duration was 11.2 months （ 3 - 21 months） , and one year survival rate was 54.3 %. The major toxicity included neutropenia, nausea, vomiting and diarrhea, impaired liver function, febrile neutropenia, etc. The severity of these side effect was in grade Ⅰ-Ⅱ and well tolerated. Among 49 cases,23 cases of leukopenia（46.9% ） was significantly higher than that of nausea in 11 cases（ 22.4% ） ,vomiting in 5 cases （10.0%）, abnormal liver function in 4 cases（8. 0% ）. Fever in 1 case（2.0%） （X^2 = 3.879,P〈0.05;X^2 =8.451,8.778,9. 123,9.741,all P〈0.01）. Conclusion Pemetrexed combination with carboplatin was effective in the first line treatment of advanced non-small cell lung cancer,with mild to moderate side effect ＇and safety in clinical practice.

关 键 词：非小细胞肺癌 培美曲塞 卡铂 一线 老年 

分 类 号：R734[医药卫生—肿瘤]