摘要
背景与目的:晚期肺癌一线化疗有效率仅30%～40%。复发或初治无效患者的治疗,需引入新的药物及治疗方法。培美曲塞(alimta)为多靶点抗叶酸化疗药物,于2004年8月被批准用于晚期NSCLC的二线治疗。本研究探讨培美曲塞单药或联合化疗方案治疗晚期复发性非小细胞肺癌(NSCLC)的疗效以及不良反应。方法:经病理学或细胞学确诊的复发性晚期NSCLC患者68例,其中男性45例,女性23例,中位年龄58岁。单药治疗:培美曲塞500mg/m2,第1天静脉滴注,每3周重复;联合治疗:培美曲塞500mg/m2第1天+顺铂70mg/m2第1天静脉滴注,每3周重复;或培美曲塞500mg/m2第1天+卡铂300mg/m2第1天静脉滴注,每3周重复。评价疗效及不良反应。结果:68例中无完全缓解病例,部分缓解2例,稳定41例,进展25例,疾病控制率63%(43/68)。中位无疾病进展时间2.9个月,其中鳞癌2.3个月,腺癌3.2个月,其他3.1个月,非鳞癌优于鳞癌,差异有显著性(P=0.0029)。主要不良反应为粒细胞下降、贫血和胃肠道反应。结论:培美曲塞单药或联合方案治疗一线治疗失败的难治型NSCLC疗效确切,对非鳞癌更具有治疗优势。不良反应发生率低,耐受性较好。
Background and purpose： The effective rate of first-line chemotherapy for advanced lung cancer is 30%-40%. Treatment of advanced chemo-recurrent patients needs new drugs and treatment methods. Pemetrexed （alimta） as a multi-target antifolate chemotherapeutic drug, was approved for the second-line treatment of advanced non-small cell lung cancer（NSCLC） in August 2004.The purpose of this study was to evaluate the efficacy and side effects of pemetrexed alone or pemetrexed combined with cisplatin/carboplatin in the treatment of advanced recurrent （NSCLC）. Methods： Sixty-eight patients with advanced NSCLC who had failed to previous chemotherapy were enrolled in this study and all of these patients had been confirmed with pathology or cytology. Among the 68 cases, 45 cases were male and 23 were female, the median age was 58 years, Single agent regimen： patients received pemetrexed 500 mg/m^2 on day I, by intravenous infusion, with every 21 days. Combination regimen： patients received pemetrexed 500 mg/m^2 on day 1 and cisplatin 60 mg/m^2 or carboplatin 300 mg/m^2 on day 2 by intravenous infusion, with 21 days as one cycle. All patients who received 2 or more cycles could be evaluated. Results： There was no case with complete response.2 cases had partial response, 41 had stable disease and 25 cases had progressive disease. The disease control rate was 63%（43/68）. The median survival time was 2.9 months and of which 2.3 months in squamous cell carcinoma; adenocarcinoma, 3.2 months; 3.1 months on the others, respectively. There was significant difference between squamous cell carcinoma and non-squamous cell carcinoma. The common adverse effects were leucopenia, anemia and gastrointestinal response. Conclusion： Pemetrexed or pemetrexed combined with cisplatin/carboplatin is effective and feasible for advanced recurrent NSCLC. Pemetrexed is one of the choices for NSCLC patients who failed first line chemotherapy therapy.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2009年第2期118-121,共4页
China Oncology
关键词
培美曲塞
复发
肺肿瘤
顺铂
卡铂
pemetrexed
recurrence
lung neoplasm
cisplatin
carboplatin
