培美曲塞治疗晚期胃肠道恶性肿瘤的疗效评估  

Investigation of Pemetrexed- based Chemotherapy on Advanced Gastrointestinal Cancer

作　　者：张雯[1] 崔成旭[1] 刘俊宝[1] 周爱萍[1] 杨林[1] 依荷芭丽.迟 孙永琨[1] 宋岩[1] 王金万[1] 

机构地区：[1]中国医学科学院肿瘤医院内科,北京市100021

出　　处：《中国全科医学》2015年第17期2042-2045,共4页Chinese General Practice

摘　　要：目的：评价含培美曲塞的化疗方案二线或三线治疗晚期胃肠道恶性肿瘤的疗效和毒副作用。方法选取2011-01-01至2013-12-31中国医学科学院肿瘤医院内科收治的晚期胃癌和晚期结直肠癌患者34例，其中晚期胃癌17例，晚期结直肠癌17例。患者在二线或三线治疗选择含培美曲塞的方案，培美曲塞的用法为500 mg/m2，静脉滴注，1次/3周或300 mg/m2，静脉滴注，1次/2周。根据RECIST 1.0版标准评价疗效，并计算客观有效率和疾病控制率，同时采用NCI-CTC3.0标准评价毒副作用，随访无进展生存时间（ PFS）和总生存时间（ OS）。结果晚期胃癌患者中部分缓解（PR）1例，稳定（SD）8例，进展（PD）8例，客观有效率为5.8％，疾病控制率为52.9％；PFS为0.5～10.2个月，中位PFS为2.8个月；OS为1.5～18.0个月，中位OS为9.5个月。晚期结直肠癌患者中PR 3例，SD 5例，PD 9例，客观有效率为17.6％，疾病控制率为47.1％；PFS为0.7～5.8个月，中位PFS为2.0个月；OS为1.6～16.3个月，中位OS为10.2个月。28例患者发生消化道反应，12例发生骨髓抑制，无化疗相关性死亡病例。结论含培美曲塞的方案治疗晚期胃肠道恶性肿瘤有一定疗效，毒副作用轻，耐受性好。Objective To evaluate the efficacy and toxicity of pemetrexed-based chemotherapy as the second-line or third-line treatment on patients with advanced gastrointestinal cancer. Methods We enrolled 17 patients with advanced gastric cancer and 17 patients with advanced colorectal cancer who were admitted into the Department of Oncology of the Cancer Institute and Hospital of Chinese Academy of Medical Sciences from January 1,2011 to December 31,2013. The subjects were administrated with pemetrexed therapy in the second-line or third-line treatment with a dose of 500 mg/m2 once every three weeks or a dose of 300 mg/m2 twice every two weeks also by intravenous drip. We evaluated the efficacy based on RECIST 1. 0 standard,and calculated the objective effective rate and disease control rate. The toxic and side effects were evaluated using NCI-CTC3. 0,and follow-up visits were made to monitor progression-free survival（PFS）and overall survival（OS）. Results 〈br〉 Among the subjects with advanced gastric cancer,partial remission（ PR） occurred in 1 subject,stable disease（ SD） in 8 subjects,and progressive disease（PD）in 8 subjects,with an objective effective rate of 5. 8% and a disease control rate of 52. 9%;the PFS ranged from 0. 5 to 10. 2 months with a median of 2. 8 months;the OS ranged from 1. 5 to 18. 0 months with a median of 9. 5 months. Among the subjects with advanced colorectal cancer,PR occurred in 3 subjects,SD in 5 subjects,and PD in 9 subjects with an objective effective rate of 17. 6% and a disease control rate of 47. 1%;the PFS ranged from 0. 7 to 5. 8 months with a median of 2. 0 months;the OS ranged from 1. 6 to 16. 3 months with a median of 10. 2 months. We noted gastrointestinal reaction in 28 subjects and myelosuppression in 12 subjects. No death relevant with chemotherapy occurred. Conclusion Pemetrexed-based chemotherapy on advanced gastrointestinal cancer showed curative effect to some extent with mild toxicity and well tolerance.

关 键 词：胃肠肿瘤 培美曲塞 药物疗法 联合 治疗结果 

分 类 号：R735[医药卫生—肿瘤]