培美曲塞联合铂类化疗治疗弥漫型恶性胸膜间皮瘤的疗效和不良反应

Evaluation of Efficacy and Adverse Reactions of Pemetrexed Combined with Platinum-based Chemotherapy for Treatment of Malignant Pleural Mesothelioma

目的：探讨培美曲塞联合铂类化疗治疗弥漫型恶性胸膜间皮瘤的疗效和安全性。方法：回顾性分析2006年2月至2008年2月于中山大学肿瘤医院和武汉大学中南医院采用培美曲塞联合铂类方案化疗,初治弥漫型胸膜间皮瘤14例,总结其临床资料、随访其生存情况并分析其不良反应。结果：14例患者化疗的有效率为35.7%（5/14）,疾病控制率为71.0%（10/14）,中位无进展时间为5个月（95%置信区间3.2-6.8月）,总中位生存时间为8个月（95%置信区间6.2-9.8月）。常见的不良反应包括恶心、呕吐、疲乏、中性粒细胞减少等,所有患者未观察到化疗相关死亡。结论：培美曲塞联合铂类方案初治晚期弥漫型恶性胸膜间皮瘤具,有一定的疗效和安全性,值得进一步研究和推广。

Objective：To preliminarily evaluate the efficacy and toxicity of pemetrexed combined with platinum agents as a first-line treatment of advanced malignant pleural mesothelioma. Methods ： We retrospectively reviewed the clinical data, and survival and adverse reactions among fourteen patients who received pemetrexed combined with platinum between February 2006 and February 2008 as an initial treatment for diffuse malignant pleural mesothelioma at Cancer Center of Sun Yat-Sen University and Zhongnan Hospital of Wuhan University. Results： The overall response rates of all these 14 patients was 35.7% （5/14） and the disease control rate was 71.0% （10/14）. The median survival was estimated at 8 months （95% confidence interval, 6.2 to 9.8 months） and the median time to progression was 5 months （95% confidence interval, 3.2 to 6.8 months）. Common adverse reactions included nausea, vomiting, fatigue, neutropenia, and so on. No chemotherapy related death was observed in both arms. Conclusion： The efficacy and toxicity of the regiments of pemetrexed combined with platinum in the first-line treatment of advanced malignant pleural mesothelioma were preliminarily confirmed, which may justify further research and widespread use.