培美曲塞治疗19例复发性晚期非小细胞肺癌

Pemetrexed for the treatment of advanced recurrent NSCLC

背景与目的:晚期复发的非小细胞肺癌治疗效果差,可选择的药物不多。本研究探讨培美曲塞单药或联合顺铂/卡铂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19例,其中男性9例,女性10例,中位年龄48岁,KPS评分≥70。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500 mg/m2第1天+顺铂60 mg/m2第2天静脉滴注每3周重复;或培美曲塞500 mg/m2第1天+卡铂300 mg/m2第2天静脉滴注每3周重复。至少2周期以上可评价疗效及不良反应。结果:19例中16例可评价疗效,全组无CR/PR病例,MR 2例,SD 10例,PD 4例,疾病控制率75%(12/16)。中位生存时间9个月,1年生存率为31%(5/16)。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铂类治疗晚期复发NSCLC疗效确切,不良反应发生率低,耐受性较好。

Background and purpose： The treatment effect of advanced recurrent non-small cell lung cancer （NSCLC） is poor, and there are not enough kinds of medicine for treating it. The purpose of this study was to evaluate the efficacy and side effects for chemotherapy with pemetrexed or pemetrexed combined with cisplatin/carboplatin in the treatment of advanced recurrent NSCLC. Methods： The study was conducted on nineteen patients with advanced NSCLC who had failed to previous chemotherapy and all these patients had been confirmed with pathology or cytology. Among the 19 cases, 9 cases were male and 10 were female, the median age was 48 years old, KPS scale was 70-100. Single agent regimen： patients received pemetrexed 500 mg/m^2 on day 1, by intravenous infusion, with every 21 days. Combination regimen： pa- tients 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 or partial response . Two cases got minimal response, ten got stable disease and four cases got progression disease. So the disease controlling rate was 75% （12/16）. The median survival time was nine months and 1 year-survival rate was 31% （5/16）. The common adverse effects were leucopenia, anemia and gastrointestinal response. Conclusions： Chemotherapy with pemetrexed or pemetrexed combined with cisplatin/carboplatin is effective and feasible for advanced recurrent NSCLC. So pemetrexed is one of the choices for NSCLC patients who need two or more line therapy.