老年晚期非小细胞肺癌表皮生长因子受体-酪氨酸激酶抑制剂一线治疗获得性耐药后培美曲塞化疗的疗效和安全性观察  

The efficacy and safety of pemetrexed in senile patients with advanced non-small cell lung cancer after resistance to first line EGFR-TKIs therapy

作　　者：黄韵坚[1] 庄武[1] 吴标[1] 黄章洲[1] 黄诚[1] 

机构地区：[1]福建省肿瘤医院内科福建医科大学教学医院,福建福州350014

出　　处：《临床和实验医学杂志》2016年第18期1764-1766,共3页Journal of Clinical and Experimental Medicine

基　　金：福建省科技厅引导性项目资助(2015Y0011);国家临床重点专科建设项目资助

摘　　要：目的探讨老年晚期非小细胞肺癌表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)一线治疗获得性耐药后培美曲塞化疗的疗效和安全性。方法选择经病理学确诊的表皮生长因子受体-酪氨酸激酶抑制剂一线治疗获得性耐药的老年晚期肺腺癌患者42例,化疗方案:培美曲塞500 mg/m2第1天+卡铂(AUC=5)第1天,21 d为1周期,并口服地塞米松、叶酸和肌肉注射维生素B12以减轻毒性反应。根据实体瘤疗效评价标准RECIST 1.1和美国国立癌症研究所制定的不良反应标准(NCI-CTC 4.0)对疗效和不良反应进行评价。结果部分缓解18例(42.8%),疾病稳定12例(28.6%),疾病进展12例(28.6%),疾病控制率71.4%。中位无进展生存期为5.1个月,中位生存期为12.6个月。化疗相关毒副作用较轻,最常见的为骨髓抑制和胃肠道反应,且多为Ⅰ、Ⅱ级。结论培美曲塞联合卡铂治疗EGFR-TKIs一线治疗后获得性耐药的老年晚期非小细胞肺癌的具有较好疗效且可耐受。Objective To evaluate the efficacy and safety of pemetrexed in senile patients with advanced non - small cell lung cancer after resistance to first line EGFR - TKIs therapy. Methods Clinical data of 4 2 senile patients with advanced lung adenocarcinoma after resistance to first line EGFR - TKIs therapy were reviewed. Combination regimen patients received pemetrexed 5 0 0 mg/m^2 on day 1 and carboplatin （ AUC = 5） d1 , by intravenous infusion, with 21 days as one cycle. Folic, dexamethasone, acid and vitamin B12 were applied to relieve the drug toxicity. The objective response rate was estimated by Response evaluation Criteria in Solid Tumors （RECIST 1.1） and the toxicity was estimated by National Cancer Institute Common Toxicity Criteria（ version 4. 0）. Results There was 18 patients reached partial response, constituting a total of 42. 8% ; 12 patients reached stable disease, constituting a total of 28. 6% . 12 patients reached progressive disease, constituting a total of 28. 6% . The disease control rate was 71.4%. The median progression free survival （PFS） was 5. 1 months. The median overall survival （OS） was 12. 6 months. The drug - related adverse events were myelosuppression, gastrointestinal response, most of which were grade Ⅰ to Ⅱ. Conclusion Pemetrexed combined with carboplatin is effective and feasible for senile patients with advanced pulmonary adenocarcinoma as chemotherapy treatment.[

关 键 词：非小细胞肺癌 培美曲塞 化疗 

分 类 号：R734.2[医药卫生—肿瘤]