培美曲塞联合顺铂治疗老年肺腺癌的疗效分析  

Curative effect analysis of Pemetrexed Combined with Cisplatin in elderly patients with lung adenocarcinoma

作　　者：陈荧[1] 

机构地区：[1]广东省佛山市高明区人民医院,528500

出　　处：《首都食品与医药》2016年第20期52-54,共3页Capital Food Medicine

摘　　要：目的分析培美曲塞联合顺铂化疗与营养支持治疗对老年肺腺癌患者的临床疗效及安全性。方法采用回顾性分析近年来我院收治的88例ECOG≤2分且年龄≥70岁的老年肺腺癌的临床资料,根据是否应用培美曲塞二钠化疗的不同分为培美曲塞组（研究组,n=44）和最佳营养支持治疗组（对照组,n=44）。研究组给予顺铂120mg/m2（d1）＋培美曲塞二钠500mg/m2（d2）方案化疗,每21天为1个完整周期,并在化疗同时给予地塞米松、叶酸及维生素B12以减轻不良反应。对照组给予最佳营养对症支持治疗,包括能量、止咳平喘、止痛等。研究组分别对完成2个周期及4个周期化疗的患者评价药物疗效和化疗药物的不良反应。结果 A组完全缓解（CR）1例（2.2%）,部分缓解（PR）12例（27.3%）,病情稳定（NC）19例（43.2%）,病情进展（PD）13例（27.3%）。B组CR0例,PR0例,NC15例（34.1%）,PD29例（65.9%）。B组中位PFS2个月（0.5-5个月）,中位OS5个月（2-13个月）,1、2、3年生存率22.3%,8.9%,0%;A组中位PFS为6个月（1.5-12个月）,中位生存（OS）为10个月（4-18个月）（与B组比较,P≤0.05）,1、2、3年生存率56.3%,22.7%,2.2%。结论对于ECOG≤2分且年龄≥70岁晚期肺腺癌的老年患者,培美曲塞二钠疗效优于最佳营养支持治疗,无明显毒副反应,患者可以耐受。objective Analysis of the clinical efficacy and safety of Pemetrexed Combined with Cisplatin and Nutritional support therapy on elderly patients with lung adenocarcinoma.Methods This is a retrospective study including 88 elderly patients of adenocarcinoma of the lung, ECOG≤2 and older than 70. They were divided into the A group（n=44） and the B group with the best supportive care（n=44） depending on whether the application of chemotherapy with pemetrexed. The A group accepted cisplatin120mg/m-2（d1）＋pemetrexed 500mg/m-2（d2）, every 21 days as a cycle. Dexamethasone, folic acid and vitamin B 12 were applied to relieve the adverse reactions. The curative effect and adverse reactions were assessed after two or four therapeutic cycles for the B group.Results In the A group there were 1 patients of CR（2.2%）, 12 patients of PR（27.3%）, 19 patients of NC（43.2%） and 13 patients of PD（27.3%）. In the B group, there were 0 patients of CR, 0 patients of PR, 15 patients of NC（34.1 %） and 29 patients of PD（65.9%）. Conclusion The Pemetrexed Combined with Cisplatin contrast to the best supportive care has better treatment effect and adverse reaction in patients of ECOG≤2 and older than 70 with adenocarcinoma of the lung, and the toxicity could be tolerated.

关 键 词：培美曲塞 顺铂 化疗 肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]