培美曲塞持续巩固治疗老年进展期非小细胞肺癌的生存期及安全性分析  

Survival and safety analysis of continuation maintenance therapy with pemetrexed in the elderly patients with progressive non-small cell lung cancer

作　　者：潘士勇[1] 杨民[2] 樊卫飞[3] 王峻[3] 

机构地区：[1]中国人民解放军南京军区南京总医院干部保健科,江苏省南京市210002 [2]江苏省老年医院干部保健科,江苏省南京市210024 [3]江苏省老年医院血液肿瘤科,江苏省南京市210024

出　　处：《实用老年医学》2015年第2期116-118,共3页Practical Geriatrics

摘　　要：目的评价培美曲塞持续巩固治疗在治疗老年进展期非小细胞肺癌(NSCLC)中的临床价值及安全性。方法 82例老年进展期NSCLC患者接受4周期培美曲塞/卡铂方案诱导化疗,56例疾病控制者以2∶1随机分为巩固治疗组和对照组。其中巩固治疗组继续接受培美曲塞单药巩固治疗至疾病进展或出现不可耐受的不良反应,比较2组无疾病进展生存期(PFS)、总生存期(OS)以及化疗相关毒性反应。结果巩固治疗组与对照组PFS分别为4.0月和3.4月(P<0.05),中位OS分别为14.2月和11.2月(P>0.05)。巩固治疗的不良反应可耐受,其中1/2级乏力10例(27%),贫血7例(18.9%);3/4级贫血4例(10.8%)。结论培美曲塞持续巩固治疗是治疗老年进展期NSCLC的一种安全、有效的措施,可以提高患者的PFS。Objective To evaluate the clinical value and safety of continuation maintenance therapy with pemetrexed in the elderly patients with progressive non-small cell lung cancer（ NSCLC）. Methods Eighty-two elderly patients with progressive NSCLC were treated with pemetrexed plus carboplatin for 4 cycles. Those who presented with effective outcome after induction therapy were randomly assigned（ 2∶ 1） to maintenance group or control group. Patients in maintenance group received maintenance therapy with pemetrexed until disease progression or unacceptable toxicity appeared. The progressionfree survival（ PFS）,overall survival（ OS） and toxicity were compared between two groups. Results Thirty-seven patients showed effective outcome after induction therapy. The median PFS of maintenance group and control group were 4. 0months and 3. 4 months（ P〈0. 05）,while OS of the two groups were 14. 2 months and 11. 2 months（ P〉0. 05）. In maintenance group,the toxicity was tolerable with 10 cases of grade 1 /2 fatigue（ 27%）,7 cases of anemia（ 18. 9%）,and 4cases of grade 3 /4 anemia（ 10. 8%）. Conclusions Continution maintenance therapy with pemetrexed is effective and safe for the elderly patients with progressive NSCLC.

关 键 词：老年人 进展期非小细胞肺癌 培美曲塞 巩固治疗 

分 类 号：R734.2[医药卫生—肿瘤]