培美曲塞联合顺铂/卡铂—线治疗Ⅲb/Ⅳ期肺腺癌临床分析  

Pemetrexed combined with cisplatin/carboplatin as first-line treatment for stage Ⅲb/Ⅳ adenocarcinoma of the lung

作　　者：曾赟[1] 夏国豪[1] 蒋峰[2] 

机构地区：[1]江苏省肿瘤医院内科,南京210009 [2]江苏省肿瘤医院胸外科,南京210009

出　　处：《同济大学学报（医学版）》2012年第1期88-93,共6页Journal of Tongji University(Medical Science)

基　　金：江苏省卫生厅科研项目(H200873)

摘　　要：目的观察培美曲塞联合顺铂或培美曲塞联合卡铂一线治疗Ⅲb/Ⅳ期肺腺癌的疗效及安全性。方法对52例经病理组织学或细胞学检查确诊的Ⅲb/Ⅳ期肺腺癌初治患者进行培美曲塞联合顺铂化疗或培美曲塞联合卡铂化疗。培美曲塞500mg/m^2,第1天,静脉滴注;顺铂25 mg/m^2,第1～3天,静脉滴注;卡铂(AUC=5),第1天,静脉滴注,每3周为1个周期重复。连用2～6个周期,每2周期进行疗效评价。结果可评价的52例病例中,完全缓解(CR)0例,部分缓解(PR)19例,稳定(SD)22例,进展(PD)11例,有效率(RR)36.5%,疾病控制率(DCR)78.8%,中位疾病无进展时间(PFS)4.1个月。全组毒副反应较轻,主要为骨髓抑制及胃肠道反应,无治疗相关死亡。顺铂组和卡铂组RR分别为37.1%和35.3%,DCR分别为80.0%和76.5%,PFS分别为4.2个月和4.1个月;老年组和非老年组RR分别为31.3%和38.9%,DCR分别为75.0%和80.6%,PFS分别为3.9个月和4.3个月,以上的差异均无统计学意义(P>0.05)。两组患者毒副反应较轻,且组间比较差异无统计学意义。结论培美曲塞联合顺铂或卡铂一线治疗Ⅲb/Ⅳ期肺腺癌疗效肯定,毒副反应较轻,可作为Ⅲb/Ⅳ期肺腺癌的一线治疗方法。Objective To investigate the clinical efficacy and toxicity of pemetrexed combined with cisplatin/carboplatin as first-line treatment for patients with stage Ⅲb/Ⅳ adenocarcinoma of the lung. Methods Fifty-two chemotherapy-naive patients with stage IIIb or IV adenocarcinoma of the lung were enrolled in this study and all were confirmed by pathology or cytology. Patients received pemetrexed 500 mg/㎡ on the first day and cisplatin 25mg/㎡ from the first day to the third days or carboplatin （ AUC = 5） on the first day. The therapy was repeated for 2 - 6 cmycles with 3 weeks as a cycle. Patients were evaluated as they complete every 2 cmycles. Results All 52 patients were evaluable for Objective response, there were 0 cmase of CR, 19 cmases of PR, 22 cmases of SD and 11 cmases of PD with an overall response rate （RR） of 36.5%, disease control rate （DCR） of 78.8%. The progression free survival （PFS） was 4.1 months. The adverse effects were mild and mainly were hematological toxicity and gastrointestinal response. There was no treatment-related death during the study. The RR of cisplatin and carboplatin groups were 37.1% and 35.3 % （ P 〉 0.05 ） ; DCR were 80.0% and 76.5 % （ P 〉 0.05 ） ; PFS were 4.2 months and 4.1 months （ P 〉 0.05 ）, respectively. The RR of elderly group （≥70y） and non-elderly group （〈70y） were 31.3% and 38.9% （P 〉0.05） ; DCR were 75.0% and 80.6% （ P 〉 0.05 ） ; PFS were 3.9 months and 4.3 months （ P 〉 0.05 ）, respectively. Both the two groups presented mild adverse effects, and there were no statistical differences between them. Conclusion Pemetrexed combined with cisplatin/carboplatin shows good clinically efficacy and low side effects as the first-line treatment for patients with stage Ⅲb/Ⅳ adenocarcinoma of the lung and should be considered as a standard therapeutic protocol.

关 键 词：非小细胞肺肿瘤 培美曲塞 顺铂 卡铂 化疗 

分 类 号：R734.2[医药卫生—肿瘤]