培美曲塞治疗非小细胞肺癌无症状脑转移临床分析  

Clinical efficacy of pemetrexed in the treatment of non-small cell lung cancer with asymptomatic brain metastasis

作　　者：胡琼[1] 任胜祥[1] 李爱武[1] 陈晓霞[1] 陈佳艳[1] 孟淑燕[1] 何雅亿[1] 王永生[1] 况鹏[1] 李冰[1] 周彩存[1] 

机构地区：[1]同济大学附属上海市肺科医院肿瘤科,上海200433

出　　处：《肿瘤》2011年第8期756-760,共5页Tumor

摘　　要：目的:培美曲塞已被确定为晚期非小细胞肺癌(非鳞癌)的标准用药之一。本研究旨在探讨培美曲塞治疗非小细胞肺癌无症状脑转移的近期疗效和不良反应。方法:回顾性分析2008年11月—2010年12月45例非小细胞肺癌无症状脑转移患者的临床资料,评价疗效和不良反应。结果:所有患者颅内转移灶的疗效:部分缓解17例(37.8%),疾病稳定20例(44.4%),疾病进展8例(17.8%),客观缓解率为37.8%,疾病控制率为82.2%。全身病灶的总体疗效:部分缓解5例(11.1%),疾病稳定16例(35.6%),疾病进展24例(53.3%),客观缓解率为35.6%,疾病控制率为46.6%。颅内转移灶与全身病灶的疾病控制率差异有统计学意义(P=0.006),而客观缓解率差异无统计学意义(P>0.05)。颅内转移灶的无进展生存期为3.87个月,全身病灶的中位无进展生存期为2.27个月,差异有统计学意义(P=0.009)。颅内转移灶的近期疗效与患者年龄、性别、吸烟状况、脑转移灶数目、是否接受放疗等临床特征之间无明显相关性(P>0.05)。未观察到严重不良反应。结论:培美曲塞对于非小细胞肺癌脑转移患者颅内转移灶具有较好的疗效,不良反应较小。Objective： Pemetrexed is a multitargeted antifolate inhibitor used as a standard agent in patients with advanced non-small cell lung cancer （NSCLC） （non-squamous cell）. The purpose of this study was to evaluate the short-term efficacy and adverse effects of pemetrexed in the treatment of NSCLC patients with asymptomatic brain metastasis. Methods： The clinical records of 45 NSCLC patients with asymptomatic brain metastasis receiving pemetrexed between November 2008 and December 2010 were analyzed. The efficacy and adverse effects were evaluated. Results： Local cerebral response assessment showed that 17 patients （37.8%） got a partial response （PR）, 20 （44.4%） had a stable disease （SD） and 8 （17.8%） had a progressive disease （PD）. The objective response rate was 37.8%, and the disease control rate was 82.2%. General lesion assessment presented that 5 （11.1%）, 16 （35.6%） and 24 （53.3%） patients got PR, SD and PD, respectively. The objective response rate was 35.6%, and the disease control rate was 46.6%. There was a significant difference in the disease control rate （P=0.006） but not in the objective response rate （P0.05） between the local cerebral disease and the general lesion. Median progression-free survivals for cerebral and extracerebral diseases were 3.87 months and 2.27 months, respectively （P=0.009）. The short-term efficacy of cerebral disease was not associated with age, gender, smoking status, the number of brain metastatic lesions and radiotherapy. No serious adverse events were observed. Conclusion： Pemetrexes demonstrates a higher efficacy against cerebral metastasis of NSCLC, and the adverse effects are minor.

关 键 词：癌 非小细胞肺 脑转移 培美曲塞 

分 类 号：R734.2[医药卫生—肿瘤]