培美曲塞二钠二线治疗晚期肺腺癌32例临床观察  

Pemetrexed as Second-Line Therapy for Advanced Pulmonary Adenocarcinoma

作　　者：魏卫[1] 管峦[1] 戴秀梅[1] 袁保兰[1] 

机构地区：[1]江苏省徐州市中心医院肿瘤科,221009

出　　处：《中华全科医学》2011年第11期1689-1690,共2页Chinese Journal of General Practice

摘　　要：目的观察培美曲塞二钠二线治疗32例晚期肺腺癌患者的近期疗效及不良反应。方法 32例经病理学确诊既往化疗失败的进展期肺腺癌患者,其中男性19例,女性13例,中位年龄61岁。单药组:培美曲塞500 mg/m2,第1天静脉滴注;联合组:培美曲塞500 mg/m2第1天+顺铂20 mg/m2第1～4天,均为每3周重复,并口服地塞米松、叶酸和肌肉内注射维生素B12以减轻毒副反应。完成2个周期及以上评价疗效和不良反应。结果 32例患者中,完全缓解0例,部分缓解4例,客观有效率12.5%,稳定18例,进展10例,疾病控制率68.8%,疾病进展时间3.1个月。主要不良反应为骨髓抑制和胃肠道反应。结论培美曲塞二钠作为二线治疗化疗失败的晚期肺腺癌,具有较好的疗效和安全性。Objective To observe the efficacy and safety of pemetrexed as second-line therapy in treatment of 32 patients with advanced pulmonary adenocarcinoma.Methods A total of 32 patients with pathologically confirmed pulmonary adenocarcinoma were enrolled in this study.19 cases were male and 13 were female,the median age was 61 years.Single agent regimen：patients received pemetrexed 500 mg/m2 on day 1,by intravenous infusion,with every 21 days.Combination regimen：patients received pemetrexed 500 mg/m2 on day 1 and cisplatin 20 mg/m2 on day 1-4 by intravenous infusion,with 21 days as one cycle.Patients also received oral dexamethasone,oral folic acid and im.Vitamin B12 supplementation was added to reduce toxicity.All patients who received 2 or more cycles could be evaluated.Results All of 32 patients were evaluable for response and toxicity.The objective response rate was 12.5%（4/32）.The disease control rate was 68.8%（22/32）.The median time to progress（TTP） was 3.1 months.The common adverse effects were bone marrow suppression and gast rointestinal toxicity.Conclusion Pemetrexed is effective and safe in treating patients with locally advanced or metastatic pulmonary adenocarcinoma after failure of previous chemotherapy.

关 键 词：培美曲塞二钠 肺腺癌 化学治疗 

分 类 号：R734.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]