培美曲塞联合沙利度胺二线治疗晚期肺腺癌的疗效分析  

Effect of pemetrexed combined with thalidomide on treatment of patients with advanced pulmonary adenocarcinoma

作　　者：丁德权[1] 陈磊[1] 何昌霞[1] 

机构地区：[1]安徽省马鞍山市人民医院肿瘤介入科,安徽马鞍山243000

出　　处：《实用临床医药杂志》2014年第3期69-71,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321493)

摘　　要：目的探讨培美曲塞联合沙利度胺治疗晚期肺腺癌的疗效及毒副作用。方法选取25例一线治疗失败、经病理学或细胞学确诊为晚期肺腺癌的患者作为研究对象。化疗方案:培美曲塞500 mg/m2,第1天静脉滴注,每3周重复;沙利度胺25 mg/d起,后每天增加25 mg,至200 mg/d维持,每2个周期评价临床疗效,每周期进行毒副作用评价。结果 25例患者中完全缓解(CR)0例,部分缓解(PR)7例,疾病稳定(SD)10例,疾病进展(PD)8例,总有效率为28%,疾病控制率(DCR)为68%。中位无进展生存期(PFS)为4.1个月,中位生存期(MST)为7.1个月,1年生存率为32%。主要毒副作用为骨髓抑制、消化道反应及纳差乏力,多以I^II度为主。结论培美曲塞联合沙利度胺治疗晚期复治肺腺癌患者疗效确切,毒副作用少,值得临床推广。Objective To explore the efficacy and adverse reactions of pemetrexed combined with thalidomide in the treatment of patients with advanced pulmonary adenocarcinoma. Methods 25 advanced pulmonary adenocarcinoma patients failed in previous therapy were collected and treated with the chemotherapy as follow： 500 mg/m2 pemetrexed, intravenous injection on day 1, repeti- tion every 3 weeks; starting with 25 mg thalidomide, and increasing 25 mg daily to 200 mg to maintain. The efficiency was assessed every 2 cycles and adverse reactions were assessed every one cycle. Results In 25 patients, no case of complete remission （CR）, 7 cases of partial remission （PR）, 10 cases of stable disease （SD） and 8 cases of progressive disease （PD）. The overall response and disease control rate （DCR） were 28% and 68% respectively. The median progression - free survival （PFS） and median survival time （MST） were 4.1 and 7.1 months respectively. Survival rate within one year was 32 %. The major adverse reactions were myelosuppression, gastrointestinal reactions, poor appetite and fatigue, mainly at grades I - II. Conclusion For re - treatment pa- tients with advanced pulmonary adenocarcinoma, pemetrexed combined with thalidomide shows a definite efficacy with less adverse reactions, so it is worthy of clinical popularization.

关 键 词：培美曲塞 沙利度胺 复治 晚期肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]