培美曲塞二钠在晚期肺腺癌患者同药维持治疗中的临床疗效  

Clinical efficacy of pemetrexed disodium in maintenance treatment of advanced lung adenocarcinoma

作　　者：宁涓 胡立娟 王晓燕 龚浩[1] Juan Ning;Lijuan Hu;Xiaoyan Wang;Hao Gong(Department of Oncology and Hematology,Beijing Haidian Hospital,Beijing 100080,China;Department of Oncology,Beijing Huairou Hospital,Beijing 101400,Beijing,China)

机构地区：[1]北京市海淀医院肿瘤血液内科,北京100080 [2]北京怀柔医院肿瘤内科,北京101400

出　　处：《中国基层医药》2023年第1期39-43,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨晚期肺腺癌患者培美曲塞二钠联合铂类化疗后应用培美曲塞二钠同药维持治疗的临床疗效和不良反应。方法:回顾性分析北京怀柔医院2013年1月至2020年8月收治的经过培美曲塞二钠联合铂类方案化疗后疾病获得控制的Ⅳ期肺腺癌患者35例的临床资料,患者联合化疗结束后开始应用培美曲塞二钠维持治疗直至疾病进展。对35例患者的临床特点、治疗效果、不良反应、无进展生存时间(PFS)及总生存时间(DS)进行评价。结果:在治疗效果上,35例患者中完全缓解(CR)0例,部分缓解(PR)11例,稳定(SD)22例,进展(PD)2例,客观缓解率(ORR)为31.4%,疾病控制率(DCR)为94.3%,中位无进展时间(MPFS)为9.53个月,中位总生存时间(MOS)为18.21个月,1年生存率为68.6%,2年生存率为31.4%,3年生存率为11.4%。不同性别、年龄、有无吸烟、培美曲塞一线或二线治疗线数基线特征均未对PFS有影响(均 P > 0.05),基因突变阳性、接受4个及4个以上化疗周期对PFS有保护作用(均 P < 0.05)。化疗相关不良反应主要为骨髓抑制、恶心、转氨酶升高、肾脏毒性。主要不良反应为轻症反应,经对症处理后可缓解。 结论:培美曲塞二钠在晚期肺腺癌患者维持治疗中疗效突出且安全性好。该研究成果具备科学性。Objective To investigate the clinical efficacy and adverse reactions of pemetrexed disodium in the maintenance treatment of advanced lung adenocarcinoma after chemotherapy with pemetrexed disodium and platinum.Methods The clinical data of 35 patients with stageⅣlung adenocarcinoma who received chemotherapy with pemetrexed disodium and platinum and were well treated in Beijing Huairou Hospital from January 2013 to August 2020 were retrospectively analyzed.Maintenance therapy with pemetrexed disodium was initiated after the completion of combination chemotherapy until disease progression.The clinical characteristics,therapeutic effects,adverse reactions,progression-free survival,and overall survival of the 35 patients were evaluated.Results Among the 35 patients,no patients had complete remission,11 patients had partial remission,22 patients had stable disease,and 2 patients had progressive disease.The objective remission rate was 31.4%,disease control rate was 94.3%,median progression-free survival was 9.53 months,median overall survival was 18.21 months,1-year survival rate was 68.6%,2-year survival rate was 31.4%,and 3-year survival rate was 11.4%.Gender,age,smoking,and the baseline characteristics of patients undergoing first-line pemetrexed disodium or second-line pemetrexed disodium treatment had no effects on progression-free survival(all P>0.05).Positive gene mutation and receiving four or more chemotherapy cycles had a protective effect on progression-free survival(both P<0.05).Chemotherapy-related adverse reactions mainly included myelosuppression,nausea,elevated transaminase,and nephrotoxicity,all of which were mild and were relieved after symptomatic treatment.Conclusion Pemetrexed disodium is effective and safe in the maintenance treatment of advanced lung adenocarcinoma.The results of this study are scientific.

关 键 词：腺癌 细支气管肺泡 维持化疗 叶酸拮抗剂 药物相关性副作用和不良反应 生活质量 安全 精准医学 回顾性研究 

分 类 号：R734.2[医药卫生—肿瘤]